Pancho - MAL-SIL-64

Code: MAL-SIL-64
Mercy ID: V-00668-01
Encounter Date: 09/05/2001
Last: Maldonado
First: Silvia
DOB: 12/10/1964
County: Dekalb
Street: 1609 Avon Avenue
City: Tucker
State: GA

Zip

30084-

Home

(404) 888-7839

Cell

(404) 247-4893

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Other

Education Level

Some College

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: 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