DEJ-FEL-66

Code
DEJ-FEL-66
Mercy ID
V-01298-01
Encounter Date
07/28/2003
Last
De jesus
First
Felisa
DOB
07/22/1966
County
Fulton
Street
116 Ashford Pl
City
Roswell
State
GA
Zip
30076-
Home
(000) 000-0000
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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