ROD-BLA-85

Code
ROD-BLA-85
Mercy ID
V-03096-01
Encounter Date
06/17/2009
Last
Rodriguez
First
Blanca
DOB
10/08/1985
County
Gwinnett
Street
4371 Winter Chapel Rd. Apt. 1305
City
Doraville
State
GA
Zip
30360-
Cell
(404) 549-0520
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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