Pancho - MOR-JOS-61

Code: MOR-JOS-61
Mercy ID: B-00013-01
Encounter Date: 01/19/1999
Last: Mora
First: Josefina
DOB: 12/24/1961
County: Dekalb
Street: 3915 Doral Circle
City: Doraville
State: GA

Zip

30360-

Home

(770) 457-3679

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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: K. Aleman