ARI-FRA-65

Code
ARI-FRA-65
Mercy ID
V-01593-01
Encounter Date
05/11/2004
Last
Arita
First
Francisca
DOB
04/20/1965
County
Gwinnett
Street
3450 Breken Rd. B 1 Apt 806
City
Duluth
State
GA
Zip
30096-
Home
(770) 921-4321
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
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
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