Code
DIA-SAM-68
Mercy ID
V-01736-02
Last
Diaz
First
Samuel
DOB
09/08/1968
County
Gwinnett
House
(678) 558-7942
CODE DATE SERVICE INTAKE BY CONTACT MODE DATA ENTRY
DIA-SAM-68 11/16/2004 Entrevista R. Miranda Face to face K. Aleman
DIA-SAM-68 11/16/2004 Information R. Miranda Face to face K. Aleman
DIA-SAM-68 11/16/2004 Intake R. Miranda Face to face K. Aleman
DIA-SAM-68 10/23/2004 Follow Up R. Miranda Telephone K. Aleman