TAV-ALB-54

Code
TAV-ALB-54
Mercy ID
V-03330-01
Encounter Date
05/18/2010
Last
Tavarez
First
Alba
DOB
05/10/1954
County
Dekalb
Street
3061 Oakcliff Rd. # 115
City
Doraville
State
GA
Zip
30340-
Home
(770) 455-9774
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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