Pancho - AGU-MAR-67

Code: AGU-MAR-67
Mercy ID: V-00682-01
Encounter Date: 09/19/2001
Last: Aguilar
First: Maria
DOB: 06/04/1967
County: Dekalb
Street: 6750 Peachtree Industrial Blv. Apt. 2005
City: Doraville
State: GA

Zip

30360-

Home

(770) 734-8090

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade school

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. Manzo
Data Entry: K. Aleman