Pancho - GON-PAU-76

Code: GON-PAU-76
Mercy ID: V-01727-01
Encounter Date: 10/19/2004
Last: Gonzalez
First: Paula
DOB: 01/26/1976
County: Dekalb
Street: Not given
City: Dalton
State: GA

Zip

00000-

Home

(770) 873-9951

Cell

(678) 789-7374

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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: 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