Pancho - MUÑ-MAR-68

Code: MUÑ-MAR-68
Mercy ID: V-01775-01
Encounter Date: 12/14/2004
Last: Muñiz
First: Margarita
DOB: 06/28/1968
County: Forsyth
Street: 116 Ann Ave.
City: Cumming
State: GA

Zip

30040-

Home

(770) 844-9013

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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
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

Intake: J. Manzo
Data Entry: K. Aleman