GON-FAT-85

Code
GON-FAT-85
Mercy ID
V-02936-01
Encounter Date
10/31/2008
Last
Gonzalez
First
Fatima
DOB
05/15/1985
County
Fulton
Street
155 Preston Oaks Drive
City
Alpharetta
State
GA
Zip
30022-
Home
(770) 667-3763
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
J. Perez
Data Entry
J. Manzo