BRO-MAR-71

Code
BRO-MAR-71
Mercy ID
V-01011-01
Encounter Date
09/09/2002
Last
Brocks
First
Maria eugenia
DOB
07/22/1971
County
Fulton
Street
791 Riverdale Dr.
City
Jonesboro
State
GA
Zip
30238-
Home
(770) 719-8748
Family Status
Two parent family w/children
COB
Venezuela
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. Perez
Data Entry
K. Aleman