Pancho - MAL-MAR-68

Code: MAL-MAR-68
Mercy ID: V-00737-01
Encounter Date: 11/05/2001
Last: Maldonado
First: Maria del carmen
DOB: 11/06/1968
County: Cobb
Street: 2200 Atlanta Rd. Apt H-4
City: Smyrna
State: GA

Zip

30080-

Home

(770) 432-7581

Family Status

Single parent w/children

COB

Mexico

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