Pancho - PED-ADR-82

Code: PED-ADR-82
Mercy ID: V-01943-01
Encounter Date: 06/22/2005
Last: Pedraza
First: Adriana
DOB: 11/05/1982
County: Other
Street: 80 Gold Creft Dr.
City: Braselton
State: GA

Zip

N/A

Home

(770) 616-6664

Cell

(706) 654-2009

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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