AYA-CON-62

Code
AYA-CON-62
Mercy ID
V-01036-01
Encounter Date
11/13/2002
Last
Ayala
First
Concepcion
DOB
03/25/1962
County
Fulton
Street
5735 Roswell Rd. Apt. 407
City
Atlanta
State
GA
Zip
30342-
Home
(404) 255-1593
Cell
(770) 777-0806
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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. Perez
Data Entry
K. Aleman