MAR-MAR-72

Code
MAR-MAR-72
Mercy ID
V-00026-01
Encounter Date
01/05/2000
Last
Pesina
First
Maria amparo
DOB
03/18/1972
County
Cobb
Street
3014 Estuary Rd.
City
Acworth
State
GA
Zip
30101-
Cell
(205) 570-1922
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
Y. Garcia