JIM-GUA-85

Code
JIM-GUA-85
Mercy ID
V-02199-01
Encounter Date
03/14/2006
Last
Jimenez
First
Guadalupe
DOB
01/04/1985
County
Douglass
Street
2308 Brodick Lane
City
Lithia springs
State
GA
Zip
30122-
Cell
(678) 895-2442
Family Status
Adult coupie-no 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
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
R. Gonzalez