ROD-MAR-55

Code
ROD-MAR-55
Mercy ID
V-02922-01
Encounter Date
10/22/2008
Last
Rodriguez
First
Maria victoria
DOB
09/08/1955
County
Gwinnett
Street
3051 Morris Lake
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 717-5678
Cell
(770) 361-7937
Family Status
Adult couple-no children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree
Home Owner
YES

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