PER-ANA-73

Code
PER-ANA-73
Mercy ID
V-02110-01
Encounter Date
10/29/2005
Last
Perez
First
Ana maria
DOB
03/11/1973
County
Dekalb
Street
3028 Chamblee Tucker Road Apt. N-6
City
Chamblee
State
GA
Zip
30341-
Cell
(678) 973-8439
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade 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
YES
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
R. Gonzalez