ANT-CIN-74

Code
ANT-CIN-74
Mercy ID
V-03111-01
Encounter Date
07/02/2009
Last
Anteliz
First
Cindy
DOB
09/12/1974
County
Douglass
Street
925 Oakcreek Apt. B
City
Douglasville
State
GA
Zip
30134-
Cell
(770) 572-3112
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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