Pancho - PER-REB-77

Code: PER-REB-77
Mercy ID: V-02025-01
Encounter Date: 09/10/2005
Last: Peregrino
First: Rebeca
DOB: 12/31/1977
County: Cobb
Street: not given
City: Kenneesaw
State: GA

Zip

N/A

Cell

(678) 923-5097

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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