BAZ-MAR-75

Code
BAZ-MAR-75
Mercy ID
V-01279-01
Encounter Date
07/11/2003
Last
Bazan
First
Maria renata
DOB
05/04/1975
County
Gwinnett
Street
65 W Mocking Bird Ln.
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 256-6218
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical
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
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