MED-RUB-80

Code
MED-RUB-80
Mercy ID
V-02956-01
Encounter Date
12/04/2008
Last
Medel
First
Rubi
DOB
12/05/1980
County
Gwinnett
Street
2302 Lion Hill Dr.
City
Norcross
State
GA
Zip
30071-
Cell
(404) 549-0520
Family Status
Single parent w/children
COB
Mexico
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
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo