BAE-VER-72

Code
BAE-VER-72
Mercy ID
B-00040-01
Encounter Date
06/16/1998
Last
Baeza
First
Veronia
DOB
01/24/1972
County
Dekalb
Street
3685 Shallowford Rd. Apt C
City
Doravilee
State
GA
Zip
30340-
Home
(000) 000-0000
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Other
Education Level
Other
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

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
K. Aleman