Pancho - PAL-SIL-78

Code: PAL-SIL-78
Mercy ID: V-02065-01
Encounter Date: 10/31/2005
Last: Palma
First: Silvia patricia
DOB: 08/16/1978
County: Gwinnett
Street: 1137 Northwood Lake
City: Duluth
State: GA

Zip

30096-

Cell

(770) 330-6130

Family Status

Two parent family w/children

COB

Ecuador

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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: J. Perez
Data Entry: R. Gonzalez