BEN-RIT-74

Code
BEN-RIT-74
Mercy ID
V-01936-01
Encounter Date
06/09/2005
Last
Benito
First
Rita
DOB
05/28/1974
County
Dekalb
Street
2203 Plaster Rd. Apt E-4
City
Atlanta
State
GA
Zip
30345-
Home
(404) 235-9927
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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. Manzo
Data Entry
K. Aleman