CEC-ROS-68

Code
CEC-ROS-68
Mercy ID
V-01301-01
Encounter Date
08/04/2003
Last
Ceciliano
First
Rosalba
DOB
02/08/1968
County
Dekalb
Street
4185 English Oak Dr.
City
Doraville
State
GA
Zip
30340-
Home
(770) 572-3120
Family Status
Single parent w/children
COB
Costa Rica
Gender
Female
Housing
Doubling Up
Education Level
College Degree
Home Owner
YES

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