Pancho - MAT-KAR-82

Code: MAT-KAR-82
Mercy ID: V-02038-01
Encounter Date: 09/28/2005
Last: Matos
First: Karina
DOB: 03/23/1983
County: Dekalb
Street: 3028 Chamblee Tucker Apt. E-1
City: Chamblee
State: GA

Zip

30341-

Home

(770) 458-8276

Cell

(404) 993-0762

Family Status

Two parent family w/children

COB

Perú

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: J. Perez
Data Entry: R. Gonzalez