CON-ALB-67

Code
CON-ALB-67
Mercy ID
V-00524-01
Encounter Date
09/16/2002
Last
Contreras
First
Alberta
DOB
09/25/1967
County
Fulton
Street
10450 Worthengton Hills M
City
Roswell
State
GA
Zip
30076-
Home
(770) 256-5661
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school
Home Owner
No

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
YES
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
J. Manzo
Data Entry
K. Aleman