Pancho - ALV-BEL-67

Code: ALV-BEL-67
Mercy ID: V-01804-01
Encounter Date: 01/13/2005
Last: Alvarez
First: Belen
DOB: 04/16/1967
County: Dekalb
Street: 1241 Mount Vermont Dr.
City: Lawrenceville
State: GA

Zip

30044-

Cell

(678) 368-2060

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Vocational/Technical

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. Perez
Data Entry: K. Aleman