Pancho - MEN-OBI-48

Code: MEN-OBI-48
Mercy ID: V-00507-01
Encounter Date: 09/16/2002
Last: Mendoza
First: Obilia
DOB: 04/01/1948
County: Gwinnett
Street: 3386 Rolling Ridge Dr.
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 923-2960

Family Status

Adult coupie-no children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

Adult, no formal education

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
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: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman