CAN-EUG-75

Code
CAN-EUG-75
Mercy ID
V-02481-01
Encounter Date
05/02/2007
Last
Canales
First
Eugenia
DOB
12/05/1975
County
Dekalb
Street
3510 Buford Hwy.
City
Atlanta
State
GA
Zip
30329-
Home
(404) 396-0780
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Shelter
Education Level
Grade 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
J. Perez
Data Entry
J. Manzo