REY-ROS-80

Code
REY-ROS-80
Mercy ID
V-03162-01
Encounter Date
09/01/2009
Last
Reyna
First
Rosa
DOB
07/20/1980
County
Gwinnett
Street
12208 Magnolia Point Blv.
City
Duluth
State
GA
Zip
30096-
Cell
(404) 838-9252
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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