Pancho - WIL-MAR-58

Code: WIL-MAR-58
Mercy ID: V-00113-01
Encounter Date: 02/17/2000
Last: Wilson
First: Martha
DOB: 02/28/1958
County: Cobb
Street: 1235 Mountain Spring Dr.
City: Kenessaw
State: GA

Zip

30064-

Home

(678) 290-1243

Family Status

Single parent w/children

COB

Perú

Gender

Female

Housing

Doubling Up

Education Level

Vocational/Technical

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: S. Aviña