Pancho - WEL-MAR-68

Code: WEL-MAR-68
Mercy ID: V-01184-01
Encounter Date: 04/08/2003
Last: Wellman
First: Maria
DOB: 12/16/1968
County: Gwinnett
Street: 940 Twin Brock
City: Lawrenceville
State: GA

Zip

30043-

Home

(770) 368-8615

Family Status

Two parent family w/children

COB

Chile

Gender

Female

Housing

Doubling Up

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: 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. Perez
Data Entry: K. Aleman