CHA-MAR-82

Code
CHA-MAR-82
Mercy ID
V-01666-01
Encounter Date
07/30/2004
Last
Chavez
First
Maria eliazar
DOB
06/21/1982
County
Dekalb
Street
2777 Plaster Rd. Apt 10
City
Chamblee
State
GA
Zip
30345-
Home
(404) 320-6470
Family Status
Adult coupie-no 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
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