PAT-CEL-67

Code
PAT-CEL-67
Mercy ID
V-02724-01
Encounter Date
02/27/2008
Last
Patiño
First
Celia
DOB
06/02/1967
County
Gwinnett
Street
4695 W. Prise Road
City
Buford
State
GA
Zip
30518-
Home
(678) 482-9273
Cell
(678) 668-0817
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
No
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