BEJ-ADR-67

Code
BEJ-ADR-67
Mercy ID
V-03193-01
Encounter Date
10/26/2009
Last
Bejarano
First
Adriana
DOB
02/11/1967
County
Fulton
Street
1820 Bell Court Parkway
City
Roswell
State
GA
Zip
30076-
Cell
(678) 668-5060
Family Status
Single parent w/children
COB
Bolivia
Gender
Female
Housing
Single Family
Education Level
High school graduate
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