Pancho - PUL-MAR-74

Code: PUL-MAR-74
Mercy ID: V-02063-01
Encounter Date: 10/26/2005
Last: Pulido
First: Marhly
DOB: 04/13/1974
County: Gwinnett
Street: 1157 Park Forest
City: Lilburn
State: GA

Zip

30047-

Cell

(727) 645-9045

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: R. Gonzalez