Pancho - ROD-ELE-69

Code: ROD-ELE-69
Mercy ID: V-01197-01
Encounter Date: 04/23/2003
Last: Rodriguez
First: Elena
DOB: 09/15/1969
County: Dekalb
Street: 6652 Peachtree Industrial Blv. Apt L
City: Doraville
State: GA

Zip

30360-2150

Home

(404) 421-9404

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

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. Manzo
Data Entry: K. Aleman