Pancho - CAM-PAM-83

Code: CAM-PAM-83
Mercy ID: V-01111-01
Encounter Date: 02/10/2003
Last: Campino
First: Pamela
DOB: 12/20/1983
County: Gwinnett
Street: 112 Dannager Way
City: Lawrenceville
State: GA

Zip

30045-

Home

(678) 663-1591

Family Status

Two parent family w/children

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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: R. Gonzalez