Pancho - MAR-MAR-80

Code: MAR-MAR-80
Mercy ID: V-00823-01
Encounter Date: 01/23/2002
Last: Martinez
First: Marta
DOB: 09/03/1980
County: Fulton
Street: 4233 Jonesboro Rd. B-10
City: Forest park
State: GA

Zip

30297-

Home

(404) 608-1605

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
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