CAR-EMI-82

Code
CAR-EMI-82
Mercy ID
V-03298-01
Encounter Date
04/12/2010
Last
Carbajal
First
Emilia
DOB
06/18/1982
County
Gwinnett
Street
955 Worcester Place
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 630-4747
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
H.S. equivalency diploma
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
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
G. Landeros
Data Entry
J. Manzo