BRA-ELV-77

Code
BRA-ELV-77
Mercy ID
V-02300-01
Encounter Date
07/05/2006
Last
Brambila
First
Elvia
DOB
09/14/1977
County
Gwinnett
Street
93 Benson St.
City
Lawrenceville
State
GA
Zip
30045-
Home
(770) 963-3571
Family Status
Two parent family w/children
COB
Mexico
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
J. Manzo