MOR-SUS-64

Code
MOR-SUS-64
Mercy ID
V-00223-01
Encounter Date
05/24/2000
Last
Moreira
First
Susana
DOB
05/24/2000
County
Gwinnett
Street
974 Pepperwood Trail
City
Norcross
State
GA
Zip
30093-
Home
(678) 380-5780
Family Status
Single parent w/children
COB
Nicaragua
Gender
Female Child
Housing
Doubling Up
Education Level
some high school
Home Owner
YES

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
Y. Garcia