BLA-MAR-66

Code
BLA-MAR-66
Mercy ID
V-00721-01
Encounter Date
10/23/2001
Last
Blazquez
First
Maria de lourdes
DOB
06/18/1966
County
Gwinnett
Street
2583 Gwinn Dr.
City
Norcross
State
GA
Zip
30071-
Home
(770) 448-6186
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
No
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