GAR-GUA-80

Code
GAR-GUA-80
Mercy ID
V-03513-01
Encounter Date
01/25/2011
Last
Garcia
First
Guadalupe
DOB
09/05/1980
County
Gwinnett
Street
3343 Holcomb Bridge Rd.
City
Norcross
State
GA
Zip
30092-
Cell
(678) 260-4395
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo