Pancho - AGU-SUS-82

Code: AGU-SUS-82
Mercy ID: V-01937-01
Encounter Date: 06/22/2005
Last: Aguirre
First: Susana
DOB: 03/10/1982
County: Fulton
Street: Not given
City: Atlanta
State: GA

Zip

N/A

Home

(404) 853-5130

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Shelter

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: 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. Manzo
Data Entry: K. Aleman