Pancho - MON-MAR-73

Code: MON-MAR-73
Mercy ID: V-02043-01
Encounter Date: 10/05/2005
Last: Mondragon
First: Maria elena
DOB: 01/02/1973
County: Dekalb
Street: 00000
City: 00000
State: GA

Zip

00000-

Cell

(770) 572-9328

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Other

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: Volunteer
Data Entry: R. Gonzalez