KEA-ETH-55

Code
KEA-ETH-55
Mercy ID
V-00145-01
Encounter Date
03/22/2000
Last
Keasler
First
Ethel
DOB
07/31/1955
County
Cobb
Street
1660 Squire Dr
City
Mariette
State
GA
Zip
30008-
Home
(770) 435-3155
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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
J. Perez
Data Entry
D. Gomez