APA-SUS-76

Code
APA-SUS-76
Mercy ID
V-03169-01
Encounter Date
10/13/2009
Last
Aparicio
First
Susana
DOB
07/30/1976
County
Gwinnett
Street
5911 Hunt Club Run # D
City
Norcross
State
GA
Zip
30093-
Cell
(770) 369-0910
Family Status
Single parent 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

NO 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