MIR-RUF-69

Code
MIR-RUF-69
Mercy ID
V-03091-01
Encounter Date
06/03/2009
Last
Miranda
First
Rufina
DOB
09/26/1969
County
Dekalb
Street
2418 Dunwoody Crossing Apt. A
City
Atlanta
State
GA
Zip
30338-
Cell
(678) 368-2054
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
J. Perez
Data Entry
J. Manzo