CAN-GUA-58

Code
CAN-GUA-58
Mercy ID
V-00481-01
Encounter Date
06/25/2001
Last
Canedo
First
Guadalupe
DOB
06/27/1958
County
Dekalb
Street
2628 Boland Dr.
City
Atlanta
State
GA
Zip
30319-
Home
(404) 636-4698
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high 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
No
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. Manzo
Data Entry
K. Aleman