Pancho - MON-MAR-58

Code: MON-MAR-58
Mercy ID: V-00055-01
Encounter Date: 02/01/2000
Last: Montenegro
First: Maria elena
DOB: 05/24/1958
County: Dekalb
Street: 3061 Oakcliff Rd Apt-41
City: Doraville
State: GA

Zip

30340-

Home

(770) 451-2622

Family Status

Single adult

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

College Degree

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: D. Gomez