ROM-ANG-54

Code
ROM-ANG-54
Mercy ID
V-01497-01
Encounter Date
02/23/2004
Last
Romero
First
Angela
DOB
03/23/1954
County
Dekalb
Street
Ponce de Leon
City
Atlanta
State
GA
Zip
00000-0000
Home
(770) 645-8903
Family Status
Two parent family 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
Abuso fue por el cuñado. Alfonso es el cuñado
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