Pancho - ANT-ALE-71

Code: ANT-ALE-71
Mercy ID: V-01366-01
Encounter Date: 10/06/2003
Last: Antunez
First: Alejandra
DOB: 12/04/1971
County: Cobb
Street: 3018 Landmark Dr.
City: Marietta
State: GA

Zip

30060-

Home

(770) 438-1726

Cell

(678) 525-9845

Family Status

Single parent 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. Manzo
Data Entry: K. Aleman