GOM-MAR-77

Code
GOM-MAR-77
Mercy ID
V-02891-01
Encounter Date
09/15/2008
Last
Gomez
First
Martha
DOB
08/10/1977
County
Fulton
Street
3289 Myrple St.
City
Hapeville
State
GA
Zip
30315-
Cell
(678) 522-2224
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education
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