FIT-ANA-72

Code
FIT-ANA-72
Mercy ID
V-03274-01
Encounter Date
03/01/2010
Last
Fitzgerald
First
Ana
DOB
09/20/1972
County
Gwinnett
Street
1540 Maple Point Court
City
Lawrenceville
State
GA
Zip
30043-
Cell
(678) 768-2034
Family Status
Single adult
COB
Venezuela
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma
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
G. Landeros
Data Entry
J. Manzo