CRU-ISA-76

Code
CRU-ISA-76
Mercy ID
V-00956-01
Encounter Date
06/11/2002
Last
Cruz
First
Isabel
DOB
07/04/1976
County
Fulton
Street
2032 Bolton Rd. NW Apt. 3
City
Atlanta
State
GA
Zip
30318-
Home
(404) 605-0259
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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