JIM-SIL-65

Code
JIM-SIL-65
Mercy ID
V-00296-02
Encounter Date
09/26/2000
Last
Jimenez
First
Silverio
DOB
03/05/1965
County
Fulton
Street
5801 Kingsport Dr. Apt. 202
City
Roswell
State
GA
Zip
30342-
Home
(404) 459-7184
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
College Degree
Home Owner
YES

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
F. Perez
Data Entry
Y. Garcia