GAR-ROS-55

Code
GAR-ROS-55
Mercy ID
V-02308-01
Encounter Date
08/28/2006
Last
Garcia
First
Rosa
DOB
01/25/1951
County
Gwinnett
Street
893 Brandwood Way NW
City
Lilburn
State
GA
Zip
30047-
Home
(770) 925-0833
Family Status
Single parent w/children
COB
Mexico
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
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