MEL-MAR-70

Code
MEL-MAR-70
Mercy ID
V-01040-01
Encounter Date
11/22/2002
Last
Melgoza
First
Maria elena
DOB
02/07/1970
County
Gwinnett
Street
4673 Vintage Ct.
City
Buford hwy
State
GA
Zip
30518-
Home
(678) 714-1057
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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. Manzo
Data Entry
K. Aleman