PAD-GRA-77

Code
PAD-GRA-77
Mercy ID
V-03446-01
Encounter Date
10/04/2010
Last
Padilla
First
Graciela
DOB
07/26/1977
County
Dekalb
Street
3180 Clairmont
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 909-7398
Family Status
Single parent w/children
COB
Mexico
Gender
Male Child
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

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