MAE-LIA-72

Code
MAE-LIA-72
Mercy ID
V-02335-01
Encounter Date
09/26/2006
Last
Martinez
First
Eliana
DOB
04/19/1972
County
Gwinnett
Street
5105 Westover Cr.
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 886-9725
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma
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
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
G. Landeros
Data Entry
J. Manzo