Pancho - ROS-RAY-45

Code: ROS-RAY-45
Mercy ID: V-00801-01
Encounter Date: 01/18/2002
Last: Rosas
First: Raymunda
DOB: 10/05/1945
County: Gwinnett
Street: 4421 Lee Rd Apt. 1
City: Snellville
State: GA

Zip

30039-

Home

(678) 344-3070

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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: 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. Manzo
Data Entry: K. Aleman