TAP-MDR-69

Code
TAP-MDR-69
Mercy ID
V-00038-01
Encounter Date
01/19/2000
Last
Tapia
First
Maria del rocio
DOB
06/14/1969
County
Gwinnett
Street
P.O. Box 28
City
Lilburn
State
GA
Zip
30048-
Home
(404) 316-4013
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school
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

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
K. Aleman