Pancho - AYA-GAB-70

Code: AYA-GAB-70
Mercy ID: V-01181-01
Encounter Date: 04/02/2003
Last: Ayala
First: Gabriela
DOB: 11/20/1970
County: Dekalb
Street: 3817 Church St.
City: Clarkston
State: GA

Zip

30021-

Cell

(404) 508-1422

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman