CAM-CLA-76

Code
CAM-CLA-76
Mercy ID
V-00947-01
Encounter Date
06/18/2002
Last
Campos
First
Clarisa
DOB
09/14/1976
County
Dekalb
Street
328 Chamblee Tucker RD .
City
Atlanta
State
GA
Zip
30341-
Home
(770) 220-0232
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
College Degree
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
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. Manzo
Data Entry
K. Aleman