Pancho - GAR-ROM-67

Code: GAR-ROM-67
Mercy ID: V-00984-01
Encounter Date: 08/14/2002
Last: Garcia
First: Romelia
DOB: 03/13/1967
County: Dekalb
Street: 3427 Cumberland Apt. 1
City: Chamblee
State: GA

Zip

30341-

Home

(678) 530-9141

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: 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. Perez
Data Entry: K. Aleman