GAL-MAR-74

Code
GAL-MAR-74
Mercy ID
V-01669-01
Encounter Date
07/30/2004
Last
Galvan
First
Maria engracia
DOB
04/16/1974
County
Dekalb
Street
4775 Hairston Crossing Dr.
City
Stone mountain
State
GA
Zip
30083-
Home
(404) 447-7123
Cell
(770) 475-9354
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
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