HIT-ANA-75

Code
HIT-ANA-75
Mercy ID
V-03422-01
Encounter Date
09/20/2010
Last
Hitth
First
Ana
DOB
04/18/1975
County
Dekalb
Street
0660 Kimberland Rd.
City
Decatur
State
GA
Zip
30047-
Cell
(678) 789-1524
Family Status
Single parent w/children
COB
Honduras
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