Pancho - SOT-GIS-69

Code: SOT-GIS-69
Mercy ID: V-01955-01
Encounter Date: 06/30/2005
Last: Soto
First: Gisela
DOB: 05/26/1969
County: Dekalb
Street: not given
City: Doraville
State: GA

Zip

30340-

Home

(000) 000-0000

Family Status

Single adult

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: 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