ROI-MAR-65

Code
ROI-MAR-65
Mercy ID
V-03043-01
Encounter Date
10/14/2009
Last
Rodriguez
First
Mary ann
DOB
06/13/1965
County
Dekalb
Street
1205 Welllington Ct. Apts
City
Decatur
State
GA
Zip
30034-
Family Status
Single adult
COB
USA
Gender
Female
Housing
Doubling Up
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. Perez
Data Entry
J. Manzo