SUA-ROS-78

Code
SUA-ROS-78
Mercy ID
V-00383-01
Encounter Date
01/10/2001
Last
Suazo
First
Rosalba
DOB
07/04/1978
County
Dekalb
Street
2115 Coosawattee Dr. Apt. J-5
City
Atlanta
State
GA
Zip
30319-
Home
(404) 636-4107
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
J. Manzo
Data Entry
K. Aleman