VAR-IRI-76

Code
VAR-IRI-76
Mercy ID
V-03348-01
Encounter Date
06/21/2010
Last
Vargas
First
Iris
DOB
10/10/1976
County
Fulton
Street
11 Sweetberry Cr.
City
Alpharetta
State
GA
Zip
30005-
Cell
(404) 587-8863
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo