MAT-FEL-60

Code
MAT-FEL-60
Mercy ID
V-00400-01
Encounter Date
01/26/2001
Last
Mata
First
Felisa
DOB
11/20/1960
County
Dekalb
Street
478 pine dr. p.o. box 163
City
Pine lake
State
GA
Zip
30072-
Home
(404) 299-3865
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
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
S. Aviña