URB-MAR-91

Code
URB-MAR-91
Mercy ID
V-02992-01
Encounter Date
02/03/2009
Last
Urbano
First
Martha
DOB
11/03/1991
County
Dekalb
Street
1425 Northcliff Valley Way
City
Atlanta
State
GA
Zip
99999-
Cell
(404) 914-2302
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school
Home Owner
YES

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