Pancho - SAN-SUS-79

Code: SAN-SUS-79
Mercy ID: V-00035-01
Encounter Date: 01/17/2000
Last: Sanchez
First: Susana
DOB: 05/11/1979
County: Fulton
Street: 865 -H Tahoe Rd
City: Roswell
State: GA

Zip

30076-

Home

(770) 506-5059

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Some College

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: 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. Manzo
Data Entry: D. Gomez