Pancho - CHA-MAR-71

Code: CHA-MAR-71
Mercy ID: V-01203-01
Encounter Date: 04/22/2003
Last: Chacon
First: Marta
DOB: 11/21/1971
County: Fulton
Street: 663 Northwood Dr. NE Apt. 160
City: Atlanta
State: GA

Zip

30342-

Home

(770) 745-1914

Cell

(770) 754-6343

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Not Homeless

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: 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