LOP-MAG-85

Code
LOP-MAG-85
Mercy ID
V-03310-01
Encounter Date
04/22/2010
Last
Lopes
First
Magdalena
DOB
10/03/1985
County
Dekalb
Street
1313 Brook Ave.
City
Doraville
State
GA
Zip
30340-
Cell
(678) 600-7094
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
J. Manzo