GAM-ROS-58

Code
GAM-ROS-58
Mercy ID
V-02577-01
Encounter Date
08/21/2007
Last
Gambettea
First
Rosa
DOB
03/04/1958
County
Cobb
Street
413 Left Trace
City
Marietta
State
GA
Zip
30064-
Cell
(678) 698-5867
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Not Homeless
Education Level
Post Grad 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
G. Landeros
Data Entry
J. Manzo