GOM-MAR-80

Code
GOM-MAR-80
Mercy ID
V-02776-01
Encounter Date
05/14/2008
Last
Gomez
First
Maria
DOB
08/16/1980
County
Gwinnett
Street
2004 Marsh Creek Dr.
City
Lawrenceville
State
GA
Zip
30043-
Cell
(678) 499-9192
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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. Perez
Data Entry
J. Manzo