Pancho - JIM-ALI-80

Code: JIM-ALI-80
Mercy ID: V-02015-01
Encounter Date: 07/25/2005
Last: Jimenez
First: Alicia
DOB: 02/24/1980
County: Gwinnett
Street: 5149 Rock Borough Trl.
City: Norcross
State: GA

Zip

30071-

Home

(770) 449-9602

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Some College

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: G. Landeros
Data Entry: R. Gonzalez