FAR-REB-81

Code
FAR-REB-81
Mercy ID
V-03509-01
Encounter Date
01/21/2011
Last
Farfan
First
Rebeca
DOB
03/16/1981
County
Fulton
Street
1184 Lowe Lane
City
Roswell
State
GA
Zip
30076-
Cell
(678) 964-0227
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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. Perez
Data Entry
J. Manzo