PER-MAT-79

Code
PER-MAT-79
Mercy ID
V-02551-01
Encounter Date
07/25/2007
Last
Perez
First
Matilde
DOB
03/14/1979
County
Cobb
Street
546 Benmark Ct.
City
Smyrna
State
GA
Zip
30080-
Cell
(770) 895-0023
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
G. Landeros
Data Entry
J. Manzo