ESP-ALM-76

Code
ESP-ALM-76
Mercy ID
V-00121-01
Encounter Date
02/29/2000
Last
Espinoza
First
Alma
DOB
02/28/1976
County
Paulding
Street
2390 Fairburn Rd. Lot 49
City
Douglasville
State
GA
Zip
30135-
Home
(678) 838-9394
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
Signed consent form and promesa before the fire
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
Y. Garcia