PER-DAN-75

Code
PER-DAN-75
Mercy ID
V-03406-01
Encounter Date
08/30/2010
Last
Perez
First
Daniela
DOB
10/20/1975
County
Fulton
Street
15155 North Valleyfield Rd.
City
Milton
State
GA
Zip
30005-
Cell
(678) 608-7129
Family Status
Single parent w/children
COB
Colombia
Gender
Female
Housing
Other
Education Level
some high 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
J. Perez
Data Entry
J. Manzo