Pancho - SIL-DAI-83

Code: SIL-DAI-83
Mercy ID: V-02067-01
Encounter Date: 11/02/2005
Last: Silve servin
First: Daisy
DOB: 05/20/1983
County: Dekalb
Street: 6750 Peachtree Industrial Bld.
City: Doraville
State: GA

Zip

30360-

Cell

(678) 499-3410

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high school

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: 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