Pancho - UBA-NAN-81

Code: UBA-NAN-81
Mercy ID: V-01597-01
Encounter Date: 05/14/2004
Last: Uballe
First: Nancy
DOB: 01/01/1981
County: Gwinnett
Street: 1898 Libby Lane
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 995-5994

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high school

Home Owner

YES

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