Pancho - ROJ-BER-69

Code: ROJ-BER-69
Mercy ID: V-01824-01
Encounter Date: 02/01/2005
Last: Rojo
First: Bertha
DOB: 08/22/1969
County: Gwinnett
Street: 207Treehouse Pkwy
City: Norcross
State: GA

Zip

30093-

Home

(770) 723-0465

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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. Perez
Data Entry: K. Aleman