IGN-SEL-79

Code
IGN-SEL-79
Mercy ID
V-03353-01
Encounter Date
06/29/2010
Last
Ignacio
First
Selene
DOB
12/23/1979
County
Fulton
Street
2431 Morosgo Way # E
City
Atlanta
State
GA
Zip
30324-
Cell
(404) 370-2137
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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

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