AUS-AMB-81

Code
AUS-AMB-81
Mercy ID
V-02353-01
Encounter Date
10/23/2006
Last
Austen
First
Ambar
DOB
02/12/1981
County
Dekalb
Street
not given
City
Nodio
State
GA
Zip
00000-
Cell
(678) 549-1334
Family Status
Unknow/Unreported
COB
USA
Gender
Female
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