ARE-SUS-89

Code
ARE-SUS-89
Mercy ID
O-00002-01
Encounter Date
03/22/2010
Last
Arellano
First
Susana
DOB
05/03/1989
County
Gwinnett
Street
999 No quiso dar
City
Norcross
State
GA
Zip
30340-
Cell
(404) 484-4294
Family Status
Single parent w/children
COB
USA
Gender
Female
Housing
Doubling Up
Education Level
some high school
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

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