Pancho - WAD-ZEI-56

Code: WAD-ZEI-56
Mercy ID: V-01332-01
Encounter Date: 08/27/2003
Last: Wade
First: Zeidy
DOB: 06/11/1956
County: Gwinnett
Street: 4637 Alpine Dr.
City: Lilburn
State: GA

Zip

30047-

Home

(770) 972-5425

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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