Pancho - SAN-MIN-78

Code: SAN-MIN-78
Mercy ID: V-00517-01
Encounter Date: 09/25/2002
Last: Sanchez
First: Minerva
DOB: 11/23/1978
County: Gwinnett
Street: 5682 Fairburn Rd.
City: Douglasville
State: GA

Zip

30134-

Home

(770) 947-3987

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Some College

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
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