DEL-MAR-64

Code
DEL-MAR-64
Mercy ID
V-03271-01
Encounter Date
02/25/2010
Last
De la rosa
First
Maria
DOB
01/01/1964
County
Clayton
Street
9 Marlett Lane
City
Riverdale
State
GA
Zip
30296-
Cell
(678) 949-6721
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education
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
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