CHE-LOR-76

Code
CHE-LOR-76
Mercy ID
V-01157-01
Encounter Date
03/17/2003
Last
Cheque
First
Lorena
DOB
07/13/1976
County
Dekalb
Street
2621 Oak Shadow Ct. Apt. F
City
Atlanta
State
GA
Zip
30345-
Home
(770) 582-0839
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