GIL-LIZ-76

Code
GIL-LIZ-76
Mercy ID
V-03379-01
Encounter Date
08/11/2010
Last
Gilmore
First
Lizzeta
DOB
03/16/1976
County
Fulton
Street
2110 Summer Lake Dr.
City
Atlanta
State
GA
Zip
30350-
Home
(678) 851-0967
Cell
(678) 851-0967
Family Status
Two parent family w/children
COB
Venezuela
Gender
Female
Housing
Single Family
Education Level
Some College
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. Perez
Data Entry
J. Manzo