Pancho - VEL-ELI-69

Code: VEL-ELI-69
Mercy ID: V-01890-01
Encounter Date: 04/20/2005
Last: Velazquez
First: Elizabeth
DOB: 03/14/1969
County: Dekalb
Street: 4371 Winter Chapel Rd. #2218
City: Doraville
State: GA

Zip

30360-

Cell

(678) 754-9979

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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