Pancho - MAR-BEA-66

Code: MAR-BEA-66
Mercy ID: V-00937-01
Encounter Date: 05/29/2002
Last: Martinez
First: Beatriz
DOB: 11/18/1966
County: Paulding
Street: 74 Cagle Way
City: Hiram
State: GA

Zip

30141-

Home

(770) 505-1595

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Other

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. Manzo
Data Entry: K. Aleman