LOR-ROS-84

Code
LOR-ROS-84
Mercy ID
V-03518-01
Encounter Date
01/31/2011
Last
Lora
First
Rosario
DOB
05/07/1984
County
Fulton
Street
1313 Gran Court
City
Roswell
State
GA
Zip
30076-
Cell
(678) 993-5910
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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

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