Pancho - RIV-REY-54

Code: RIV-REY-54
Mercy ID: V-00110-01
Encounter Date: 02/07/2000
Last: Rivera
First: Reyna
DOB: 01/06/1954
County: Gwinnett
Street: 4605 Friman Lane
City: Norcross
State: GA

Zip

30093-

Home

(770) 279-1594

Family Status

Adult coupie-no children

COB

Panamá

Gender

Female

Housing

Not Homeless

Education Level

Some College

Home Owner

YES

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: J. Perez
Data Entry: D. Gomez