BAL-LUZ-64

Code
BAL-LUZ-64
Mercy ID
V-01232-01
Encounter Date
05/20/2003
Last
Balsa
First
Luz marina
DOB
05/09/1964
County
Dekalb
Street
706 Jolly Ave. Sur Apt 5
City
Clarkston
State
GA
Zip
30021-
Home
(404) 298-8963
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
College Degree
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