COR-BAN-85

Code
COR-BAN-85
Mercy ID
V-03044-01
Encounter Date
04/10/2009
Last
Cordoba
First
Blanca
DOB
01/01/1985
County
Dekalb
Street
999 no la contactamos
City
Chamblee
State
GA
Zip
30341-
Cell
(678) 913-9866
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Other
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
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