Pancho - CAM-RUT-68

Code: CAM-RUT-68
Mercy ID: V-01021-01
Encounter Date: 10/25/2002
Last: Camacho
First: Ruth
DOB: 04/07/1968
County: Dekalb
Street: 2035 Idlewood Rd.
City: Tucker
State: GA

Zip

30084-

Home

(770) 493-3187

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: 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