RIO-BLA-80

Code
RIO-BLA-80
Mercy ID
V-01571-01
Encounter Date
04/20/2004
Last
Rios lopez
First
Blanca estela
DOB
10/14/1980
County
Dekalb
Street
2925 N. Dekalb Dr. 301
City
Doraville
State
GA
Zip
30340-
Home
(770) 457-5619
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Some College
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
YES
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. Manzo
Data Entry
K. Aleman