LAN-CAR-61

Code
LAN-CAR-61
Mercy ID
V-03049-01
Encounter Date
04/03/2009
Last
Landa
First
Carmen
DOB
07/12/1961
County
Gwinnett
Street
2263 Stanley Road Lt. A-7
City
Dacula
State
GA
Zip
30019-
Cell
(770) 895-9019
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Doubling Up
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
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
J. Perez
Data Entry
J. Manzo