MAR-BER-68

Code
MAR-BER-68
Mercy ID
V-02520-02
Encounter Date
06/19/2007
Last
Martinez
First
Bernardo
DOB
08/20/1968
County
Fulton
Street
1198 Long Lane
City
Roswell
State
GA
Zip
30076-
Home
(678) 252-7226
Cell
(678) 558-5366
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
Grade 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
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
J. Manzo
Data Entry
J. Manzo