Code
BER-IND-92
Mercy ID
V-00053-12
Last
Berttalioni
First
Indira
DOB
12/20/1992
County
Not given
House
(770) 562-9297
CODE DATE SERVICE INTAKE BY CONTACT MODE DATA ENTRY
BER-IND-92 01/03/2000 Intake J. Manzo Face to face D. Gomez