GAR-BLA-73

Code
GAR-BLA-73
Mercy ID
V-03156-01
Encounter Date
09/09/2009
Last
Garcia
First
Blanca ii
DOB
04/27/1973
County
Douglass
Street
4486 Cherokee Dr. Lot 56
City
Douglasville
State
GA
Zip
30134-
Cell
(404) 483-8935
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
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

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