Pancho - REY-REY-84

Code: REY-REY-84
Mercy ID: V-01992-01
Encounter Date: 07/26/2005
Last: Reyes
First: Reyna
DOB: 05/31/1984
County: Dekalb
Street: 26 Don Juan Cr.
City: Chamblee
State: GA

Zip

30341-

Home

(770) 220-0285

Family Status

Single parent w/children

COB

Honduras

Gender

Female

Housing

Doubling Up

Education Level

Grade 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: G. Landeros
Data Entry: K. Aleman