Pancho - SAN-CHR-84

Code: SAN-CHR-84
Mercy ID: V-01871-01
Encounter Date: 04/08/2005
Last: Santillan
First: Christine
DOB: 12/20/1984
County: Gwinnett
Street: 3102 Treehouse
City: Norcross
State: GA

Zip

30093-

Home

(770) 896-5110

Family Status

Single parent 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: 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: G. Landeros
Data Entry: K. Aleman