Pancho - TOR-MAR-74

Code: TOR-MAR-74
Mercy ID: V-00962-01
Encounter Date: 07/02/2002
Last: Torrez
First: Maribel
DOB: 04/14/1974
County: Gwinnett
Street: 1702 Pound Rd.
City: Stone mountain
State: GA

Zip

30028-

Home

(770) 493-4835

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high school

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. Perez
Data Entry: K. Aleman