DIA-REI-56

Code
DIA-REI-56
Mercy ID
V-03318-01
Encounter Date
05/04/2010
Last
Diaz
First
Reina
DOB
06/25/1956
County
Gwinnett
Street
898 Winging Trail
City
Lawrenceville
State
GA
Zip
30046-
Cell
(678) 863-5499
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma
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
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo