Pancho - JAI-MAR-63

Code: JAI-MAR-63
Mercy ID: V-01423-01
Encounter Date: 11/19/2003
Last: Jaime
First: Maricela
DOB: 02/03/1963
County: Hall
Street: 912 Orchard Brook DR.
City: Gainsville
State: GA

Zip

30504-

Home

(770) 572-8874

Family Status

Adult coupie-no 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: 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