BUS-TER-74

Code
BUS-TER-74
Mercy ID
V-03515-02
Encounter Date
02/01/2011
Last
Bustos
First
Tereso
DOB
10/15/1974
County
Dekalb
Street
4633 Peachtree Pl. Parkway Apt. C
City
Doraville
State
GA
Zip
30360-
Cell
(678) 500-4840
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
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
J. Manzo
Data Entry
J. Manzo