Pancho - LAN-ROS-76

Code: LAN-ROS-76
Mercy ID: V-01230-01
Encounter Date: 05/20/2003
Last: Landaverde
First: Rosalba
DOB: 11/16/1976
County: Cobb
Street: 344 Bigham ST.
City: Marietta
State: GA

Zip

30060-

Home

(678) 357-0511

Family Status

Two parent family w/children

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: 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. Perez
Data Entry: K. Aleman