Pancho - MUÑ-GEM-61

Code: MUÑ-GEM-61
Mercy ID: V-01101-01
Encounter Date: 02/06/2003
Last: Muñoz
First: Gema
DOB: 01/07/1961
County: Gwinnett
Street: 4300 Jimmy Carter Blvd. Apt. #719
City: Norcross
State: GA

Zip

30093-

Home

(678) 754-8061

Cell

(770) 723-6712

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: No
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