PIN-DAI-83

Code
PIN-DAI-83
Mercy ID
V-01170-01
Encounter Date
03/19/2003
Last
Pineda
First
Daisy
DOB
03/26/1983
County
Fulton
Street
673 Willow Creek Dr.
City
Atlanta
State
GA
Zip
30328-
Home
(404) 943-9055
Family Status
Adult coupie-no 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. Manzo
Data Entry
K. Aleman