Pancho - MAR-MAR-63

Code: MAR-MAR-63
Mercy ID: V-00027-01
Encounter Date: 01/19/2000
Last: Martinez
First: Maria guadalupe
DOB: 08/16/1963
County: Dekalb
Street: 2775 NE Expressway #01
City: Atlanta
State: GA

Zip

30345-

Home

(404) 633-3756

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high school

Home Owner

YES

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