ROG-ANT-76

Code
ROG-ANT-76
Mercy ID
V-03036-02
Encounter Date
09/01/2009
Last
Rogel
First
Antonio
DOB
06/08/1976
County
Fulton
Street
501 Connell Ave. Lot C-2
City
Atlanta
State
GA
Zip
30315-
Cell
(404) 437-3223
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high 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
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. Manzo
Data Entry
J. Manzo