Pancho - COL-LET-76

Code: COL-LET-76
Mercy ID: V-00049-01
Encounter Date: 01/25/2000
Last: Colin
First: Leticia
DOB: 11/16/1976
County: Fulton
Street: 1780 METROPOLITAN PK WAY
City: Atlanta
State: GA

Zip

30315-

Home

(404) 559-0842

Family Status

Two parent family 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: D. Gomez