RAM-CAN-78

Code
RAM-CAN-78
Mercy ID
V-01469-01
Encounter Date
01/20/2004
Last
Ramirez
First
Candy
DOB
02/02/1978
County
Gwinnett
Street
1523 Holcombridge
City
Norcross
State
GA
Zip
30092-
Cell
(678) 748-2469
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
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