Pancho - GUZ-ERI-80

Code: GUZ-ERI-80
Mercy ID: V-00934-01
Encounter Date: 05/31/2002
Last: Guzman
First: Erika
DOB: 04/03/1980
County: Polk
Street: 130 Elizabeth St.
City: Cidertown
State: GA

Zip

30125-

Home

(770) 749-9287

Cell

(770) 335-2188

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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: K. Aleman
Data Entry: K. Aleman