SAR-MAD-71

Code
SAR-MAD-71
Mercy ID
V-03278-01
Encounter Date
03/09/2010
Last
Saravia
First
Madai
DOB
10/17/1971
County
Cherokee
Street
727 Peaks Lane
City
Acworth
State
GA
Zip
30102-
Cell
(678) 702-9148
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
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. Perez
Data Entry
J. Manzo