ACO-MAR-63

Code
ACO-MAR-63
Mercy ID
V-01151-01
Encounter Date
03/11/2003
Last
Acosta
First
Maria del los angeles
DOB
10/29/1963
County
Fulton
Street
110 Pine Terrace Apt.
City
Palmeto
State
GA
Zip
30268-
Home
(770) 463-9859
Cell
(770) 969-5850
Family Status
Two parent family 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
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. Perez
Data Entry
K. Aleman