CAS-ANG-74

Code
CAS-ANG-74
Mercy ID
V-03411-01
Encounter Date
08/30/2010
Last
Casimiro
First
Angelica
DOB
03/01/1974
County
Dekalb
Street
4203 Buford Hwy NE Apt. B-6
City
Atlanta
State
GA
Zip
30345-
Cell
(404) 553-3590
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade 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
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo