ACO-MIC-82

Code
ACO-MIC-82
Mercy ID
V-01342-01
Encounter Date
09/11/2003
Last
Acosta
First
Michelle
DOB
04/15/1982
County
Fulton
Street
203 Conali Dr.
City
East point
State
GA
Zip
30344-
Home
(404) 441-0268
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school
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
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. Perez
Data Entry
K. Aleman