Pancho - BEC-ADR-69

Code: BEC-ADR-69
Mercy ID: V-01115-01
Encounter Date: 02/11/2003
Last: Becameil
First: Adriana
DOB: 11/03/1969
County: Fulton
Street: 19207 Deer Point Ct.
City: Alpharetta
State: GA

Zip

30004-

Home

(770) 663-4433

Family Status

Two parent family w/children

COB

Uruguay

Gender

Female

Housing

Not Homeless

Education Level

Some College

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