BEL-ALE-72

Code
BEL-ALE-72
Mercy ID
V-03496-01
Encounter Date
01/04/2011
Last
Bell
First
Alejandra
DOB
05/25/1972
County
Douglass
Street
850 Creekmall Rd.
City
Lithiaspring
State
GA
Zip
30122-
Cell
(404) 918-5165
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Other
Education Level
Grade school
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