GAL-SIL-68

Code
GAL-SIL-68
Mercy ID
V-02479-01
Encounter Date
04/24/2007
Last
Gallegos
First
Silvia
DOB
08/13/1968
County
Fulton
Street
1144 Thargeffmari Rd.
City
Roswell
State
GA
Zip
30076-
Cell
(770) 896-4815
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Adult, no formal education
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