GNZ-MIR-72

Code
GNZ-MIR-72
Mercy ID
V-03218-01
Encounter Date
12/03/2009
Last
Gonzalez
First
Mirtha
DOB
10/03/1972
County
Dekalb
Street
2990 Shallowford Road
City
Chamblee
State
GA
Zip
30341-
Cell
(404) 914-8452
Family Status
Single parent w/children
COB
Perú
Gender
Female
Housing
Doubling Up
Education Level
Grade school
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