Pancho - RUI-MIR-58

Code: RUI-MIR-58
Mercy ID: V-00793-01
Encounter Date: 01/09/2002
Last: Ruiz
First: Miriam
DOB: 10/28/1958
County: Gwinnett
Street: 1358 Country Down Dr.
City: Norcross
State: GA

Zip

30093-

Home

(770) 638-8682

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Post Grad Degree

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