ARR-NIC-72

Code
ARR-NIC-72
Mercy ID
V-01144-01
Encounter Date
03/11/2003
Last
Arriola
First
Nicolasa
DOB
03/11/1972
County
Cherokee
Street
319 Sletraen Way
City
Canton
State
GA
Zip
30115-
Home
(770) 720-7940
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
K. Aleman