Pancho - ARZ-ADE-73

Code: ARZ-ADE-73
Mercy ID: V-01792-01
Encounter Date: 12/24/2004
Last: Arzate
First: Adelaida
DOB: 12/16/1973
County: Cobb
Street: 329 Bell St.
City: Marietta
State: GA

Zip

30060-

Home

(770) 528-8231

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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. Manzo
Data Entry: K. Aleman