GOM-ELI-85

Code
GOM-ELI-85
Mercy ID
V-02811-01
Encounter Date
06/04/2008
Last
Gomez
First
Elisa
DOB
06/26/1985
County
Dekalb
Street
2925 Northdekalb #301
City
Doraville
State
GA
Zip
30340-
Family Status
Adult couple-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
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