ROM-LEY-81

Code
ROM-LEY-81
Mercy ID
V-03308-01
Encounter Date
04/26/2010
Last
Romero
First
Leydi
DOB
10/18/1981
County
Cobb
Street
1314 Bonfog Pass
City
Marietta
State
GA
Zip
30064-
Cell
(770) 861-0837
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical
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

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