GOM-MAG-76

Code
GOM-MAG-76
Mercy ID
V-01602-01
Encounter Date
05/18/2004
Last
Godines
First
Magna elena
DOB
11/10/1976
County
Fulton
Street
591-7 Eagle Crest
City
Roswell
State
GA
Zip
30076-
Home
(770) 552-7459
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high 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
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