Pancho - DUR-SAN-74

Code: DUR-SAN-74
Mercy ID: V-01836-01
Encounter Date: 02/24/2005
Last: Duron
First: Sandra
DOB: 02/12/1974
County: Cobb
Street: 2115 Valle Oak De.
City: Smyrna
State: GA

Zip

30030-

Home

(770) 438-7260

Cell

(404) 423-7084

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

College Degree

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: 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: G. Landeros
Data Entry: K. Aleman