PEÑ-MIR-67

Code
PEÑ-MIR-67
Mercy ID
V-00452-01
Encounter Date
03/14/2001
Last
Peña
First
Miriam
DOB
07/27/1967
County
Gwinnett
Street
2800 Herrington Woodet BLd6 Apt-303
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 376-8784
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Not Homeless
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
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
D. Gomez