Pancho - GOD-BLA-71

Code: GOD-BLA-71
Mercy ID: V-01896-01
Encounter Date: 04/27/2005
Last: Godinez
First: Blanca
DOB: 02/14/1971
County: Dekalb
Street: 2235 Plaster Rd. Apt 1
City: Atlanta
State: GA

Zip

30345-

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. Manzo
Data Entry: K. Aleman