MOR-BER-63

Code
MOR-BER-63
Mercy ID
V-03150-01
Encounter Date
08/31/2009
Last
Moreno
First
Bertha
DOB
07/23/1963
County
Gwinnett
Street
1624 Watercrest
City
Lawrenceville
State
GA
Zip
30043-
Cell
(678) 693-0257
Family Status
Single parent w/children
COB
USA
Gender
Female
Housing
Single Family
Education Level
Some College
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
J. Perez
Data Entry
J. Manzo