ADA-AND-60

Code
ADA-AND-60
Mercy ID
V-00485-02
Encounter Date
06/13/2001
Last
Adan
First
Andres
DOB
05/21/1960
County
Dekalb
Street
1450-C Northcliff Valley Way
City
Atlanta
State
GA
Zip
30319-
Home
(404) 634-4294
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
College Degree
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
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
K. Aleman
Data Entry
K. Aleman