VAL-IRI-75

Code
VAL-IRI-75
Mercy ID
V-02315-01
Encounter Date
08/09/2006
Last
Valentin
First
Iris
DOB
06/04/1975
County
Gwinnett
Street
4018 Centenal Trial
City
Duluth
State
GA
Zip
30096-
Cell
(678) 492-9892
Family Status
Two parent family w/children
COB
Puerto Rico
Gender
Female
Housing
Doubling Up
Education Level
College Degree
Home Owner
YES

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
G. Landeros
Data Entry
J. Manzo