BON-BLA-71

Code
BON-BLA-71
Mercy ID
V-01414-01
Encounter Date
11/11/2003
Last
Bonilla
First
Blanca
DOB
06/20/1971
County
Cobb
Street
1981 Hidden Glenn Dr.Apt1954
City
Marietta
State
GA
Zip
30067-
Home
(770) 919-9101
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
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