PAC-ANA-78

Code
PAC-ANA-78
Mercy ID
V-01207-01
Encounter Date
04/23/2003
Last
Pacheco
First
Ana bertha
DOB
08/28/1978
County
Gwinnett
Street
1176 Sheldy Dr.
City
Norcross
State
GA
Zip
30093-
Home
(770) 609-3143
Family Status
Single parent 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
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
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