FUE-JOS-73

Code
FUE-JOS-73
Mercy ID
V-02401-02
Encounter Date
01/30/2007
Last
Fuentes
First
Jose
DOB
10/22/1973
County
Dekalb
Street
2836 Landington Way
City
Duluth
State
GA
Zip
30096-
Home
(678) 474-9072
Cell
(678) 978-8571
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
High school graduate
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. Manzo
Data Entry
J. Manzo