CAR-PAT-75

Code
CAR-PAT-75
Mercy ID
V-00325-01
Encounter Date
10/30/2000
Last
Carrisales
First
Patricia
DOB
02/13/1975
County
Dekalb
Street
1150 Rankie st
City
Stone
State
GA
Zip
30083-
Home
(678) 457-0644
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Street
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
YES
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
D. Gomez