Pancho - VIL-REY-01

Code: VIL-REY-01
Mercy ID: V-00042-01
Encounter Date: 01/05/2000
Last: Villegas
First: Reyna
DOB: 10/19/1972
County: Dekalb
Street: 73 trevitt dr d-1
City: Stn mtn
State: GA

Zip

30083-

Home

(770) 465-4403

Family Status

Adult coupie-no 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: S. Aviña