ROD-MIR-73

Code
ROD-MIR-73
Mercy ID
V-03164-01
Encounter Date
09/21/2009
Last
Rodriguez
First
Mirza
DOB
01/25/1973
County
Clayton
Street
6753 Sallawater
City
Riverdale
State
GA
Zip
30274-
Cell
(404) 516-7868
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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