COR-ERN-75

Code
COR-ERN-75
Mercy ID
V-00619-01
Encounter Date
07/19/2001
Last
Corral
First
Ernestina
DOB
11/07/1975
County
Fulton
Street
128 Bryan St.
City
East point
State
GA
Zip
00000-0000
Home
(404) 768-3672
Family Status
Single parent 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
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
J. Perez
Data Entry
K. Aleman