Pancho - MOR-REY-70

Code: MOR-REY-70
Mercy ID: V-02019-01
Encounter Date: 09/01/2005
Last: Moreno
First: Reyna
DOB: 01/21/1970
County: Fulton
Street: 2228 Plaster Rd. #A
City: Atlanta
State: GA

Zip

30345-

Home

(404) 636-0272

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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