Pancho - JOS-MAR-76

Code: JOS-MAR-76
Mercy ID: V-01363-01
Encounter Date: 10/06/2003
Last: Martinez
First: Joselin
DOB: 08/08/1976
County: Cobb
Street: 22550 Ekerd Smith Rd.
City: Atlanta
State: GA

Zip

30339-

Home

(678) 627-9932

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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. Manzo
Data Entry: K. Aleman