MON-BLA-55

Code
MON-BLA-55
Mercy ID
V-01102-01
Encounter Date
02/05/2003
Last
Monroy
First
Blanca
DOB
05/07/1955
County
Gwinnett
Street
5575 Wylmoor Dr.
City
Norcross
State
GA
Zip
30093-
Home
(404) 936-3202
Family Status
Adult coupie-no children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
High school graduate
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
K. Aleman