Pancho - GUA-EVE-72

Code: GUA-EVE-72
Mercy ID: V-00019-01
Encounter Date: 01/06/2000
Last: Guandique
First: Evelin
DOB: 09/04/1972
County: Fulton
Street: 265 Sabrina Ct.
City: Woodstock
State: GA

Zip

30188-

Home

(770) 575-1045

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

some high school

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: Y. Garcia