ELI-ANE-78

Code
ELI-ANE-78
Mercy ID
V-00886-01
Encounter Date
04/10/2002
Last
Eliassaint
First
Anen
DOB
09/22/1978
County
Gwinnett
Street
1355 Grave Rd
City
Norcross
State
GA
Zip
30093-
Home
(770) 414-5142
Family Status
Two parent family w/children
COB
Dominican Rep
Gender
Female
Housing
Not Homeless
Education Level
High school graduate
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
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. Perez
Data Entry
K. Aleman