MAR-MON-73

Code
MAR-MON-73
Mercy ID
V-02959-01
Encounter Date
12/08/2008
Last
Martinez
First
Monica
DOB
04/11/1973
County
Gwinnett
Street
5578 Executive Way
City
Norcross
State
GA
Zip
30071-
Home
(770) 903-4787
Cell
(678) 524-8574
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate
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. Perez
Data Entry
J. Manzo