MAR-IRM-51

Code
MAR-IRM-51
Mercy ID
V-00254-01
Encounter Date
07/17/2000
Last
Martinez
First
Irma
DOB
12/12/1951
County
Gwinnett
Street
791 Terrace
City
Lawrenceville
State
GA
Zip
30044-
Home
(770) 277-5330
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical
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
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
J. Perez
Data Entry
Y. Garcia