VIL-BLA-78

Code
VIL-BLA-78
Mercy ID
V-03004-01
Encounter Date
02/17/2009
Last
Villa
First
Blanca
DOB
12/28/1978
County
Other
Street
2272 48st. # 2L
City
Astoria queens
State
NJ
Zip
11103-
Cell
(347) 792-9780
Family Status
Single parent w/children
COB
Ecuador
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
G. Landeros
Data Entry
J. Manzo