Pancho - IÑI-GRA-69

Code: IÑI-GRA-69
Mercy ID: V-02029-01
Encounter Date: 09/15/2005
Last: Iñiguez
First: Graciela
DOB: 09/10/1969
County: Gwinnett
Street: 5987 Lanier Boulevard
City: Norcross
State: GA

Zip

30071-

Cell

(678) 887-5583

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

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: YES
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: R. Gonzalez