VIL-TER-80

Code
VIL-TER-80
Mercy ID
V-02795-01
Encounter Date
05/23/2008
Last
Villalobos
First
Teresa
DOB
09/02/1980
County
Hall
Street
5024 Surthgace Dr.
City
Gainsville
State
GA
Zip
30504-
Cell
(678) 663-3197
Family Status
Single parent 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
No
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