ESP-ERI-76

Code
ESP-ERI-76
Mercy ID
V-03104-01
Encounter Date
06/29/2009
Last
Espinoza
First
Erika
DOB
03/22/1976
County
Gwinnett
Street
1435 Boggs Rd.
City
Duluth
State
GA
Zip
30096-
Home
(678) 380-0144
Cell
(678) 380-9253
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical
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
J. Perez
Data Entry
J. Manzo