PAL-SAN-72

Code
PAL-SAN-72
Mercy ID
V-02860-01
Encounter Date
07/28/2008
Last
Palacio
First
Sandra
DOB
02/28/1972
County
Gwinnett
Street
1800 Herrington Wood Ct. # 407
City
Lawrenceville
State
GA
Zip
30044-
Cell
(678) 768-9882
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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
J. Perez
Data Entry
J. Manzo