JUA-CAR-72

Code
JUA-CAR-72
Mercy ID
V-03148-01
Encounter Date
08/28/2009
Last
Juarez
First
Carmen
DOB
08/10/1972
County
Dekalb
Street
5020 Buford Hwy # 24-B
City
Chamblee
State
GA
Zip
30341-
Cell
(404) 365-5506
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