AGU-MIR-80

Code
AGU-MIR-80
Mercy ID
V-03088-01
Encounter Date
06/03/2009
Last
Aguirre
First
Mirta
DOB
12/28/1980
County
Dekalb
Street
2209 Briarcliff Rd. Apt. 10
City
Atlanta
State
GA
Zip
30329-
Cell
(678) 353-1740
Family Status
Two parent family w/children
COB
Argentina
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
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