CAD-MIR-82

Code
CAD-MIR-82
Mercy ID
V-03315-01
Encounter Date
05/03/2010
Last
Caldelas
First
Mireya
DOB
02/17/1982
County
Rockdale
Street
1103 Mill Crest Dr.
City
Conyers
State
GA
Zip
30012-
Cell
(678) 791-2115
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education
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
J. Perez
Data Entry
J. Manzo