Pancho - SIL-TER-66

Code: SIL-TER-66
Mercy ID: V-00789-01
Encounter Date: 01/09/2002
Last: Silverio
First: Teresa
DOB: 09/18/1966
County: Gwinnett
Street: 944 Amberly Ct. Apt. A
City: Norcross
State: GA

Zip

30093-

Home

(678) 924-3936

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: 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. Perez
Data Entry: K. Aleman