JUA-MIR-80

Code
JUA-MIR-80
Mercy ID
V-02129-01
Encounter Date
12/30/2005
Last
Juarez
First
Mirtala
DOB
05/21/1980
County
Dekalb
Street
3510 Buford Hwy Apt t 5
City
Atlanta
State
GA
Zip
30329-1322
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
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
Wrong #'s (404) 957-2658 & (404) 551-8687
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
J. Perez
Data Entry
R. Gonzalez