Pancho - SAL-MAR-76

Code: SAL-MAR-76
Mercy ID: V-01188-01
Encounter Date: 04/16/2003
Last: Salazar
First: Martha isabel
DOB: 12/17/1976
County: Henry
Street: 555 Davis Rd. Lt D 12
City: Stockbridge
State: GA

Zip

30281-

Home

(770) 506-2669

Family Status

Two parent family w/children

COB

Mexico

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: 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