RUI-MAR-67

Code
RUI-MAR-67
Mercy ID
V-02993-01
Encounter Date
01/28/2009
Last
Ruiz
First
Maria isabel
DOB
07/08/1967
County
Cobb
Street
1973 Leila St.
City
Austell
State
GA
Zip
30106-
Home
(770) 941-1919
Cell
(770) 633-6705
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
C. Martinez
Data Entry
J. Manzo