Pancho - PIN-FRA-71

Code: PIN-FRA-71
Mercy ID: V-01373-01
Encounter Date: 10/07/2003
Last: Pineda
First: Francis
DOB: 08/13/1971
County: Gwinnett
Street: some street
City: Lawrenceville
State: GA

Zip

00000-0000

Home

(678) 376-2446

Family Status

Single parent w/children

COB

Honduras

Gender

Female

Housing

Doubling Up

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