Pancho - LAN-GRI-63

Code: LAN-GRI-63
Mercy ID: V-01340-01
Encounter Date: 09/03/2003
Last: Landeros
First: Griselda
DOB: 04/11/1963
County: Gwinnett
Street: 5141 Hwy 78 214
City: Stone mountain
State: GA

Zip

30087-

Cell

(678) 598-2125

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Single Family

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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman