CAS-LET-79

Code
CAS-LET-79
Mercy ID
V-00442-01
Encounter Date
03/07/2001
Last
Castillo
First
Leticia
DOB
11/16/1979
County
Gwinnett
Street
1103 Lea Hill
City
Norcross
State
GA
Zip
30071-
Home
(678) 895-8629
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
Did not sign the consent form because her daughter is not with her at the time.
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