DIA-RAY-79

Code
DIA-RAY-79
Mercy ID
V-00653-01
Encounter Date
08/21/2001
Last
Diaz
First
Raymunda
DOB
11/20/1979
County
Gwinnett
Street
2536 Wind Mere Dr.
City
Norcross
State
GA
Zip
30071-
Cell
(678) 768-4099
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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. Perez
Data Entry
K. Aleman