Pancho - GAL-ARA-76

Code: GAL-ARA-76
Mercy ID: V-01947-01
Encounter Date: 06/29/2005
Last: Gallegos
First: Araceli
DOB: 05/07/1976
County: Dekalb
Street: IWH
City: Decatur
State: GA

Zip

00000-0000

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Shelter

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: 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