DAN-ROM-79

Code
DAN-ROM-79
Mercy ID
V-02818-01
Encounter Date
06/12/2008
Last
Dangelo
First
Romina
DOB
10/23/1979
County
Clayton
Street
330 Arrowhead Blvd. #410
City
Jonesboro
State
GA
Zip
30236-
Cell
(770) 603-8787
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Single Family
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