GUE-RAQ-59

Code
GUE-RAQ-59
Mercy ID
V-03302-02
Encounter Date
05/04/2010
Last
Guerra
First
Raquel
DOB
09/13/1959
County
Fulton
Street
2788 Defroors Ferry Rd. Apt. 53
City
Atlanta
State
GA
Zip
30318-
Cell
(678) 315-5574
Family Status
Two parent family w/children
COB
Guatemala
Gender
Male
Housing
Single Family
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
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

DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
J. Manzo