PER-GUA-78

Code
PER-GUA-78
Mercy ID
V-02458-01
Encounter Date
04/10/2007
Last
Perez
First
Guadalupe
DOB
10/30/1978
County
Hall
Street
6322 Mitchell Creek Dr.
City
Flowery branch
State
GA
Zip
30542-
Home
(770) 540-0958
Cell
(770) 364-9785
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school
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
YES
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