Pancho - MOR-MAR-69

Code: MOR-MAR-69
Mercy ID: V-02020-01
Encounter Date: 09/06/2005
Last: Moreno fuentes
First: Maria de la paz
DOB: 01/20/1969
County: Fulton
Street: 2214 Plaster Rd. #C
City: Atlanta
State: GA

Zip

00000-0000

Home

(404) 636-0272

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Other

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: 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: K. Aleman