QUE-GAB-65

Code
QUE-GAB-65
Mercy ID
V-03152-01
Encounter Date
08/25/2009
Last
Quezada
First
Gabriela
DOB
07/29/1965
County
Gwinnett
Street
4361 E. Meadow Dr.
City
Duluth
State
GA
Zip
30096-
Cell
(770) 597-0006
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school
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
YES
Relative
YES
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo