COS-ANA-85

Code
COS-ANA-85
Mercy ID
V-03279-01
Encounter Date
03/09/2010
Last
Coss
First
Analine
DOB
02/09/1985
County
Gwinnett
Street
5595 Running Fox Trail
City
Norcross
State
GA
Zip
30071-
Home
(678) 497-8180
Cell
(678) 206-1759
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
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
J. Perez
Data Entry
J. Manzo