CIF-NAN-80

Code
CIF-NAN-80
Mercy ID
V-03166-01
Encounter Date
09/16/2009
Last
Cifuentes
First
Nancy
DOB
01/12/1980
County
Dekalb
Street
2955 North Dekalb Dr. #301
City
Chamblee
State
GA
Zip
30340-
Cell
(770) 256-2574
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Single Family
Education Level
College Degree
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
G. Landeros
Data Entry
J. Manzo