CRU-VAL-78

Code
CRU-VAL-78
Mercy ID
V-03472-01
Encounter Date
11/10/2010
Last
Cruz
First
Valentina
DOB
10/05/1978
County
Dekalb
Street
2288 La vista Road Apt. 1
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 707-7179
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high 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
No
Relative
No
Stranger
No
NOTES
Hermana de Luz Mayra Cruz
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Manzo