GAL-MIC-83

Code
GAL-MIC-83
Mercy ID
V-03180-01
Encounter Date
10/05/2009
Last
Galabiz
First
Micaela
DOB
09/29/1983
County
Clayton
Street
971 Pinecrest Dr.
City
Forest park
State
GA
Zip
30297-
Cell
(404) 435-3736
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
J. Manzo