MEL-NUB-72

Code
MEL-NUB-72
Mercy ID
V-03192-01
Encounter Date
10/20/2009
Last
Melgar
First
Nubia
DOB
02/06/1972
County
Gwinnett
Street
740 Walnut
City
Creek Dr.
State
GA
Zip
30047-
Home
(770) 558-3392
Cell
(404) 372-9749
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Single Family
Education Level
Grade school
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
YES
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