Pancho - GAR-GUA-74

Code: GAR-GUA-74
Mercy ID: V-00466-01
Encounter Date: 04/09/2001
Last: Duran
First: Maria guadalupe
DOB: 09/12/1974
County: Dekalb
Street: 1850 Tobey Rd.
City: Chamblee
State: GA

Zip

30341-

Home

(770) 837-2045

Cell

(770) 873-0242

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade 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: YES
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman