Pancho - NIÑ-MAR-60

Code: NIÑ-MAR-60
Mercy ID: V-00758-01
Encounter Date: 12/05/2001
Last: Niño
First: Maria rosa
DOB: 06/07/1960
County: Gwinnett
Street: 3368 Timber Creek
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 381-1195

Family Status

Single parent 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