Code
CHA-BRI-92
Mercy ID
V-00684-23
Last
Chavez
First
Brian
DOB
11/24/1992
County
Cobb
House
(678) 488-9405
CODE DATE SERVICE INTAKE BY CONTACT MODE DATA ENTRY
CHA-BRI-92 09/19/2001 Intake Y. Garcia Face to face K. Aleman