GOM-AQU-68

Code
GOM-AQU-68
Mercy ID
V-01292-01
Encounter Date
07/24/2003
Last
Gomez
First
Agueda
DOB
03/29/1968
County
Gwinnett
Street
2222 Sheyenne Lane
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 886-0350
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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
Gomez, Alonso is the cousin not the partner.
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. Manzo
Data Entry
K. Aleman