GAL-FRA-65

Code
GAL-FRA-65
Mercy ID
V-03142-01
Encounter Date
08/18/2009
Last
Gallegos
First
Francisca
DOB
11/19/1965
County
Cherokee
Street
2908 Cedar Mill Dr.
City
Acworth
State
GA
Zip
30102-
Cell
(678) 592-5315
Family Status
Single parent w/children
COB
Mexico
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
YES
Relative
YES
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