RAM-MOI-70

Code
RAM-MOI-70
Mercy ID
V-03477-02
Encounter Date
11/30/2010
Last
Ramirez
First
Moises
DOB
01/28/1970
County
Gwinnett
Street
1149 Guernsey Dr.
City
Lawrenceville
State
GA
Zip
30043-
Home
(770) 339-1735
Cell
(770) 318-0038
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
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
STAY AWAY cond. Para la hija Johana que esta en DFCS
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
J. Manzo
Data Entry
J. Manzo