MED-MAR-68

Code
MED-MAR-68
Mercy ID
V-00732-01
Encounter Date
10/30/2001
Last
Medina
First
Maria
DOB
04/01/1968
County
Other
Street
30 Wedver St.
City
Carterville
State
GA
Zip
30120-
Home
(770) 607-8038
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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