BAR-RIT-73

Code
BAR-RIT-73
Mercy ID
V-00920-01
Encounter Date
05/03/2002
Last
Barron
First
Rita
DOB
05/28/1973
County
Cobb
Street
9005 Summit Wood Dr.
City
Kennesaw
State
GA
Zip
30152-
Home
(770) 419-3503
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
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