DEL-VER-67

Code
DEL-VER-67
Mercy ID
V-00391-01
Encounter Date
10/01/2001
Last
Delgado
First
Veronica
DOB
01/24/1967
County
Gwinnett
Street
10 Arnold Road
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 523-2146
Cell
(404) 227-6686
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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
K. Aleman