Pancho - MON-PAT-60

Code: MON-PAT-60
Mercy ID: V-01041-01
Encounter Date: 11/21/2002
Last: Monroe
First: Patricia
DOB: 01/13/1960
County: Fulton
Street: 3200 Lenox Rd. B 213
City: Atlanta
State: GA

Zip

30324-

Home

(404) 394-6050

Family Status

Single adult

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

College Degree

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