GON-MAR-78

Code
GON-MAR-78
Mercy ID
V-01137-01
Encounter Date
02/20/2003
Last
Gonzalez
First
Marisol
DOB
01/08/1978
County
Dekalb
Street
000 some street
City
Some city
State
GA
Zip
00000-0000
Home
(404) 641-3317
Cell
(000) 000-0000
Family Status
Single parent w/children
COB
Dominican Rep
Gender
Female
Housing
Doubling Up
Education Level
some high school
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
She didn't want to give any information
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