BUR-MAR-66

Code
BUR-MAR-66
Mercy ID
V-01227-01
Encounter Date
05/14/2003
Last
Burciaga
First
Maria guadalupe
DOB
05/06/1966
County
Gwinnett
Street
6204 Josephine Rd.
City
Doraville
State
GA
Zip
30340-
Home
(770) 441-9273
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade 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
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

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