MOR-LID-51

Code
MOR-LID-51
Mercy ID
V-03399-01
Encounter Date
09/08/2010
Last
Moreno
First
Lidia
DOB
08/03/1951
County
Gwinnett
Street
2272 Newbury Rd.
City
Norcross
State
GA
Zip
30071-
Cell
(404) 839-0664
Family Status
Adult couple-no 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
YES
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