Pancho - UPI-ROS-68

Code: UPI-ROS-68
Mercy ID: V-00518-01
Encounter Date: 09/25/2002
Last: Upiachihua
First: Rosalmira
DOB: 12/20/1968
County: Gwinnett
Street: 1503 Buford Hwy S-3
City: Atlanta
State: GA

Zip

30392-

Home

(678) 886-2247

Family Status

Two parent family w/children

COB

Perú

Gender

Female

Housing

Not Homeless

Education Level

Vocational/Technical

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

Intake: J. Perez
Data Entry: K. Aleman