MIL-ROS-74

Code
MIL-ROS-74
Mercy ID
V-03296-01
Encounter Date
04/05/2010
Last
Milian
First
Rosa
DOB
06/20/1974
County
Henry
Street
193 Toby Springs Lane
City
Mcdonal
State
GA
Zip
30253-
Cell
(404) 933-0346
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Shelter
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