MUS-SHA-73

Code
MUS-SHA-73
Mercy ID
V-02571-01
Encounter Date
08/06/2007
Last
Mustafa
First
Shannon
DOB
02/08/1973
County
Dekalb
Street
4499 Lawrenceville Hwy
City
Tucker
State
GA
Zip
30084-
Home
(770) 820-3090
Cell
(678) 334-9597
Family Status
Adult couple-no children
COB
USA
Gender
Female
Housing
Single Family
Education Level
College Degree
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
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