Pancho - GON-ELI-74

Code: GON-ELI-74
Mercy ID: V-01208-01
Encounter Date: 10/24/1974
Last: Gonzalez
First: Elisa
DOB: 10/24/1974
County: Dekalb
Street: 1454 Northcliff Valley Way
City: Atlanta
State: GA

Zip

30319-

Home

(404) 929-9066

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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. Perez
Data Entry: K. Aleman