VEN-SUS-73

Code
VEN-SUS-73
Mercy ID
V-00953-01
Encounter Date
05/24/2002
Last
Ventura
First
Susana
DOB
08/10/1973
County
Hall
Street
5565 Mulberry St.
City
Flowery branch
State
GA
Zip
30542-
Home
(678) 508-5842
Cell
(678) 887-2941
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high 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
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
YES
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
K. Aleman