VID-ROS-72

Code
VID-ROS-72
Mercy ID
V-01847-01
Encounter Date
03/08/2005
Last
Vidal
First
Rosana
DOB
05/15/1972
County
Fulton
Street
436 Norcross
City
Roswell
State
GA
Zip
30076-
Home
(770) 641-1531
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Doubling Up
Education Level
Child, not in 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
G. Landeros
Data Entry
K. Aleman