Pancho - PEÑ-VER-77

Code: PEÑ-VER-77
Mercy ID: V-01862-01
Encounter Date: 11/22/2005
Last: Peña diaz
First: Veronica
DOB: 02/03/1977
County: Dekalb
Street: 809 Regency Wood #2
City: Atlanta
State: GA

Zip

30319-

Home

(770) 912-8275

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: 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. Perez
Data Entry: R. Gonzalez