RUZ-MAR-67

Code
RUZ-MAR-67
Mercy ID
V-03001-01
Encounter Date
02/02/2009
Last
Ruiz
First
Maria
DOB
02/15/1967
County
Clayton
Street
7568 Shadow Wood Dr.
City
Jonesboro
State
GA
Zip
30236-
Cell
(404) 376-1471
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade 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