BOY-LUV-80

Code
BOY-LUV-80
Mercy ID
V-02369-01
Encounter Date
12/20/2006
Last
Boyzo
First
Luvia
DOB
12/28/1980
County
Clayton
Street
not given
City
Jonesboro
State
GA
Zip
99999-999
Home
(404) 438-4796
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
G. Landeros
Data Entry
J. Manzo