Pancho - PEÑ-EUL-79

Code: PEÑ-EUL-79
Mercy ID: V-01496-01
Encounter Date: 02/20/2004
Last: Peña
First: Eulalia
DOB: 07/12/1979
County: Gwinnett
Street: 1325 Woodington Cr.
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 685-1620

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. Perez
Data Entry: K. Aleman