Pancho - PER-MAR-82

Code: PER-MAR-82
Mercy ID: V-01391-01
Encounter Date: 10/21/2003
Last: Perez
First: Maricela
DOB: 02/12/1982
County: Fulton
Street: 502 Governor Cr.
City: Roswell
State: GA

Zip

30076-

Home

(770) 518-1382

Cell

(770) 643-8578

Family Status

Two parent family w/children

COB

Mexico

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. Perez
Data Entry: K. Aleman