Pancho - SER-VIC-66

Code: SER-VIC-66
Mercy ID: V-00747-01
Encounter Date: 11/14/2001
Last: Serrano
First: Vicky
DOB: 03/17/1966
County: Dekalb
Street: 548 South Wing Dr.
City: Lilburn
State: GA

Zip

30047-

Home

(770) 279-7137

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Not Homeless

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: 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