CAR-GEN-64

Code
CAR-GEN-64
Mercy ID
V-01026-01
Encounter Date
11/13/2002
Last
Carmona
First
Genoveva
DOB
12/25/1964
County
Gwinnett
Street
4083 Sugar Mill Dr.
City
Duluth
State
GA
Zip
30096-
Home
(678) 468-0925
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
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. Manzo
Data Entry
K. Aleman