GOM-ROX-72

Code
GOM-ROX-72
Mercy ID
V-00180-01
Encounter Date
05/17/2000
Last
Gomez
First
Roxana
DOB
03/05/1972
County
Gwinnett
Street
3402 Fox St. Apt.
City
Duluth
State
GA
Zip
30096-
Home
(678) 417-0106
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Doubling Up
Education Level
College Degree
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
S. Aviña