Pancho - CAM-ROS-73

Code: CAM-ROS-73
Mercy ID: V-01143-01
Encounter Date: 03/11/2003
Last: Campos
First: Rosa idalia
DOB: 03/09/1973
County: Dekalb
Street: 1355 Graves Rd. Apt 04-89
City: Norcross
State: GA

Zip

30093-

Home

(404) 292-1539

Family Status

Single parent w/children

COB

El Salvador

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: 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: K. Aleman