MER-MAR-91

Code
MER-MAR-91
Mercy ID
V-03236-01
Encounter Date
01/19/2010
Last
Merino
First
Maritza
DOB
06/16/1991
County
Dekalb
Street
6750 Peachtree Ind. Blvd
City
Atlanta
State
GA
Zip
30360-
Cell
(678) 886-5389
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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
J. Perez
Data Entry
J. Manzo