WIL-PER-70

Code
WIL-PER-70
Mercy ID
V-03068-01
Encounter Date
05/12/2009
Last
William
First
Perla
DOB
07/12/1970
County
Gwinnett
Street
4266 Gray Raetor Cr.
City
Snellville
State
GA
Zip
30039-
Home
(770) 982-2988
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College
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
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
G. Landeros
Data Entry
J. Manzo