AGU-MIN-77

Code
AGU-MIN-77
Mercy ID
V-00337-01
Encounter Date
11/09/2000
Last
Aguilar
First
Minerva
DOB
10/18/1976
County
Dekalb
Street
2927N. Dekald
City
Doraville
State
GA
Zip
30340-
Home
(678) 663-4124
Cell
(404) 428-2048
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
Signed consent form and promesa before the fire
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. Perez
Data Entry
Y. Garcia