VEL-EDI-54

Code
VEL-EDI-54
Mercy ID
V-02868-01
Encounter Date
08/11/2008
Last
Velazquez
First
Edith
DOB
08/02/1954
County
Gwinnett
Street
3174 Fercue Circle
City
Lawrenceville
State
GA
Zip
30044-
Cell
(678) 768-6583
Family Status
Single parent w/children
COB
Guatemala
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