GOM-DAN-90

Code
GOM-DAN-90
Mercy ID
V-02977-01
Encounter Date
12/30/2008
Last
Gomez
First
Daniela
DOB
09/02/1990
County
Forsyth
Street
2685 Visitoria Drive
City
Cumming
State
GA
Zip
30040-
Cell
(404) 453-7563
Family Status
Single adult
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
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
J. Perez
Data Entry
J. Manzo