ROJ-EDI-76

Code
ROJ-EDI-76
Mercy ID
V-01533-02
Encounter Date
03/30/2004
Last
Rojas
First
Edison
DOB
09/19/1976
County
Cobb
Street
3121 Colonial Way Apt D
City
Atlanta
State
GA
Zip
30341-
Home
(678) 571-7846
Family Status
Two parent family w/children
COB
Colombia
Gender
Male
Housing
Doubling Up
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
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
R. Miranda
Data Entry
K. Aleman