Pancho - MAR-KIM-68

Code: MAR-KIM-68
Mercy ID: V-00063-01
Encounter Date: 04/28/1999
Last: Marquez
First: Kimber
DOB: 03/07/1968
County: Clayton
Street: 6509 Granada Dr.
City: Forest park
State: GA

Zip

30297-

Home

(770) 960-0004

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

Some College

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. Manzo
Data Entry: Y. Garcia