Pancho - MEN-MAR-76

Code: MEN-MAR-76
Mercy ID: V-00935-01
Encounter Date: 05/30/2002
Last: Mendez
First: Margarita
DOB: 09/14/1976
County: Gwinnett
Street: 2825 Hamilshak Dr.
City: Bufford
State: GA

Zip

30519-

Home

(770) 271-1617

Family Status

Two parent family w/children

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