Pancho - MEL-MAR-77

Code: MEL-MAR-77
Mercy ID: V-00816-01
Encounter Date: 01/30/2002
Last: Melendez
First: Maricela
DOB: 08/12/1977
County: Gwinnett
Street: 3581 Montana Rd.
City: Buford
State: GA

Zip

30519-

Home

(770) 614-0545

Cell

(770) 614-0250

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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