CHA-ELS-74

Code
CHA-ELS-74
Mercy ID
V-02692-01
Encounter Date
01/22/2008
Last
Chavero
First
Elsa
DOB
08/22/1974
County
Cobb
Street
1509 Milcord Place
City
Marietta
State
GA
Zip
30008-
Home
(770) 435-6469
Cell
(678) 548-6250
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma
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