AMA-KAR-82

Code
AMA-KAR-82
Mercy ID
V-03303-01
Encounter Date
04/20/2010
Last
Amador
First
Karen
DOB
02/15/1982
County
Clayton
Street
159 Black Forest
City
Stockbridge
State
GA
Zip
30281-
Home
(678) 759-1582
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Single Family
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