QUI-ELK-65

Code
QUI-ELK-65
Mercy ID
V-00387-01
Encounter Date
01/17/2001
Last
Quiroga andrade
First
Elka
DOB
07/10/1965
County
Dekalb
Street
2825 Northeast spress way
City
Atlanta
State
GA
Zip
30345-
Home
(404) 636-5907
Family Status
Single adult
COB
Perú
Gender
Female
Housing
Doubling Up
Education Level
Some College
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
formed signed before the fire so original might have been lost
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
D. Gomez