COR-PAT-73

Code
COR-PAT-73
Mercy ID
V-02045-01
Encounter Date
09/30/2005
Last
Cortez
First
Patricia
DOB
11/10/1973
County
Forsyth
Street
2700 Achich Rd Apt 15
City
Cumming
State
GA
Zip
00000-
Home
(770) 205-0477
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school
Home Owner
No

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
R. Gonzalez