Pancho - GUA-SIL-79

Code: GUA-SIL-79
Mercy ID: V-00706-01
Encounter Date: 09/26/2001
Last: Guajardo
First: Silvia
DOB: 01/10/1979
County: Fulton
Street: 705 Caswyck Trace
City: Alpharetta
State: GA

Zip

30022-

Home

(678) 393-9564

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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: 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