Pancho - CAR-AMA-70

Code: CAR-AMA-70
Mercy ID: V-01648-01
Encounter Date: 07/06/2004
Last: Cardona
First: Amanda
DOB: 04/16/1970
County: Dekalb
Street: 3608 Chamblee Tucker Rd.
City: Atlanta
State: GA

Zip

30341-

Home

(678) 472-2934

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Some College

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: 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