MAR-ALF-81
- Code
- MAR-ALF-81
- Mercy ID
- V-01465-02
- Encounter Date
- 01/20/2004
- Last
- Martinez
- First
- Alfonso
- DOB
- 05/23/1981
- County
- Fulton
- Street
- 1904 Vesra Ave.
- City
- College park
- State
- GA
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
- 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
NOTES
Media
NO DOY PERMISO
- Intake
- S. Aviña
- Data Entry
- K. Aleman