Pancho - GAR-MAR-49

Code: GAR-MAR-49
Mercy ID: V-02058-01
Encounter Date: 10/06/2005
Last: Garcia
First: Maria ninfa
DOB: 11/21/1949
County: Gwinnett
Street: 1131 Diekends Rd
City: Lilburn
State: GA

Zip

30047-

Home

(404) 608-0801

Cell

(404) 862-2850

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Other

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: 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