PAN-ANT-70

Code
PAN-ANT-70
Mercy ID
V-03388-01
Encounter Date
08/10/2010
Last
Paniagua
First
Antonia
DOB
12/18/1970
County
Gwinnett
Street
5936 Poplan Rd. NE
City
Doraville
State
GA
Zip
30340-
Cell
(404) 235-8136
Family Status
Single parent w/children
COB
Guatemala
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

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