PER-BER-59

Code
PER-BER-59
Mercy ID
V-00245-02
Encounter Date
07/11/2000
Last
Perez
First
Bernando
DOB
08/30/1959
County
Cobb
Street
490 windy hill apt 1102
City
Smyrna
State
GA
Zip
30082-
Home
(770) 384-1316
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
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
R. Miranda
Data Entry
D. Gomez