Pancho - CHA-ANA-48

Code: CHA-ANA-48
Mercy ID: V-01382-01
Encounter Date: 10/13/2003
Last: Chavez
First: Ana delia
DOB: 05/23/1948
County: Cobb
Street: 1821 Killarney
City: Marietta
State: GA

Zip

30008-

Home

(770) 436-5735

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Adult, no formal education

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