Pancho - MAR-MAR-57

Code: MAR-MAR-57
Mercy ID: V-01345-01
Encounter Date: 09/08/2003
Last: Martinez
First: Maria de los a
DOB: 08/02/1957
County: Dekalb
Street: 2927 North Dekalb Dr. Apt. 107
City: Doraville
State: GA

Zip

30340-

Home

(770) 451-6949

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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