MEN-ERI-75

Code
MEN-ERI-75
Mercy ID
V-02634-01
Encounter Date
10/27/2007
Last
Mendoza
First
Erica
DOB
04/26/1975
County
Dekalb
Street
1024 Oak Chase Drive Apt. O
City
Tucker
State
GA
Zip
30084-
Cell
(770) 875-0724
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
J. Perez
Data Entry
J. Manzo