POB-MON-70

Code
POB-MON-70
Mercy ID
V-01295-01
Encounter Date
07/30/2003
Last
Poblete
First
Monica
DOB
05/18/1970
County
Gwinnett
Street
3400 Sweetwater Rd. Apt 1715
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 522-0324
Family Status
Single parent w/children
COB
Argentina
Gender
Female
Housing
Not Homeless
Education Level
Some College
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. Manzo
Data Entry
K. Aleman