CAM-ROS-42

Code
CAM-ROS-42
Mercy ID
V-00413-01
Encounter Date
02/14/2001
Last
Campos
First
Rosario
DOB
10/07/1942
County
Cobb
Street
1700 Aircraft Dr.
City
Marietta
State
GA
Zip
30060-
Home
(770) 434-0279
Family Status
Single adult
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
Signed consent form and promesa before the fire
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
K. Aleman