GUT-ELS-65

Code
GUT-ELS-65
Mercy ID
V-02296-01
Encounter Date
08/15/2006
Last
Gutierrez
First
Elsie
DOB
05/03/1965
County
Dekalb
Street
3411 Cumberland Dr.
City
Chamblee
State
GA
Zip
30084-
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical
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
J. Perez
Data Entry
J. Manzo