AVE-MAR-80

Code
AVE-MAR-80
Mercy ID
V-02057-01
Encounter Date
10/04/2005
Last
Santamaria
First
Martha
DOB
02/16/1980
County
Gwinnett
Street
5910 Hickort Spring Dr
City
Norcross
State
GA
Zip
30071-
Home
(678) 475-7414
Cell
(404) 388-8219
Family Status
Single parent w/children
COB
Ecuador
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
R. Gonzalez