Pancho - AGU-MAR-66

Code: AGU-MAR-66
Mercy ID: V-01196-01
Encounter Date: 04/21/2003
Last: Aguirre
First: Maria
DOB: 01/06/1966
County: Gordon
Street: 11 Short NW St.
City: Calhoun
State: GA

Zip

30701-

Home

(706) 624-9929

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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