PAL-DOR-83

Code
PAL-DOR-83
Mercy ID
V-03317-01
Encounter Date
05/03/2010
Last
Palma
First
Dora
DOB
05/08/1983
County
Clayton
Street
4257 Sierra Dr.
City
Forest park
State
GA
Zip
30297-
Cell
(404) 748-0013
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
YES
Relative
YES
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
G. Landeros
Data Entry
J. Manzo