FIG-MAR-04

Code
FIG-MAR-04
Mercy ID
V-02768-11
Encounter Date
05/08/2008
Last
Figueroa
First
Marylizeth
DOB
02/19/2004
County
Gwinnett
Street
1658 Broofield Way
City
Lawrenceville
State
GA
Zip
30044-
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Guadalupe Gomez 07/20/1983 Mexico
Father Edgar Figueroa 01/16/1984 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Vive con la abuela Paterna
Lives With
Grandmother
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. Perez
Data Entry
J. Manzo