GON-MAR-80

Code
GON-MAR-80
Mercy ID
V-03242-01
Encounter Date
01/27/2010
Last
Gonzalez
First
Maria de los angeles
DOB
08/02/1980
County
Clayton
Street
636 Redfox Trail
City
Jonesboro
State
GA
Zip
30238-
Cell
(678) 789-0464
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high 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