DIA-VIC-83

Code
DIA-VIC-83
Mercy ID
V-03024-01
Encounter Date
03/09/2009
Last
Diaz
First
Victoria
DOB
10/30/1983
County
Barrow
Street
1061 Fleeman Road
City
Hoschton
State
GA
Zip
30548-
Cell
(404) 484-8654
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school
Home Owner
YES

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