Pancho - MAR-MAR-29

Code: MAR-MAR-29
Mercy ID: V-01275-01
Encounter Date: 07/05/2003
Last: Martinez
First: Maria
DOB: 12/29/1970
County: Clayton
Street: 4552 Old Dixie Rd. Apt 312
City: Forest park
State: GA

Zip

30297-

Home

(404) 675-4762

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: YES
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. Perez
Data Entry: K. Aleman