ALB-DIA-78

Code
ALB-DIA-78
Mercy ID
V-03251-01
Encounter Date
02/03/2010
Last
Albert
First
Diana
DOB
02/19/1978
County
Fulton
Street
1124 Holcombs pond Circle
City
Alpharetta
State
GA
Zip
30022-
Cell
(678) 933-2834
Family Status
Two parent family w/children
COB
Mexico
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