Pancho - BON-REY-84

Code: BON-REY-84
Mercy ID: V-01451-01
Encounter Date: 12/29/2003
Last: Bonilla
First: Reyna
DOB: 12/08/1984
County: Gwinnett
Street: 2925 Wildflower Ln.
City: Snelliville
State: GA

Zip

30039-

Home

(678) 580-0742

Family Status

Single parent 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: 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