Pancho - MOR-SAN-84

Code: MOR-SAN-84
Mercy ID: V-02097-01
Encounter Date: 11/18/2005
Last: Morales
First: Sandra
DOB: 11/26/1984
County: Dekalb
Street: 5030 Westmountain St. Apt 56
City: Stone mountain
State: GA

Zip

30083-

Home

(770) 469-1839

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Some College

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