BLA-FLO-81

Code
BLA-FLO-81
Mercy ID
V-02997-01
Encounter Date
02/05/2009
Last
Blancas
First
Flor
DOB
05/29/1981
County
Rockdale
Street
146 West Meadow Lane
City
Conyers
State
GA
Zip
30012-
Home
(770) 593-1447
Cell
(770) 827-2789
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College
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