GUZ-SEV-78

Code
GUZ-SEV-78
Mercy ID
V-03270-02
Encounter Date
02/23/2010
Last
Guzman
First
Severo
DOB
10/16/1978
County
Fulton
Street
6558 Roswell Road 8-D
City
Sandy springs
State
GA
Zip
30328-
Cell
(404) 552-2162
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school
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
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. Manzo
Data Entry
J. Manzo