SER-JUA-71

Code
SER-JUA-71
Mercy ID
V-02803-01
Encounter Date
05/23/2008
Last
Serna
First
Juana
DOB
05/08/1971
County
Gwinnett
Street
956 Walnut Dr.
City
Lawrenceville
State
GA
Zip
30044-
Cell
(678) 437-0380
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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