Pancho - NEC-RAQ-57

Code: NEC-RAQ-57
Mercy ID: V-00901-01
Encounter Date: 04/18/2002
Last: Nechar
First: Raquel
DOB: 04/19/1957
County: Walton
Street: 166 Rontor Dr. Social Circle
City: Social circle
State: GA

Zip

30025-

Home

(770) 464-9186

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: 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