GOM-GWE-79

Code
GOM-GWE-79
Mercy ID
V-03227-01
Encounter Date
12/28/2009
Last
Gomez
First
Gwendolyne
DOB
11/24/1979
County
Dekalb
Street
2377 Woodside St.
City
Atlanta
State
GA
Zip
30341-
Cell
(404) 552-1661
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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

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