Pancho - PER-PAT-70

Code: PER-PAT-70
Mercy ID: V-00120-01
Encounter Date: 02/28/2000
Last: Perez
First: Patricia
DOB: 10/01/1970
County: Gwinnett
Street: 4246-f Pleasand Hill Rd
City: Duluth
State: GA

Zip

30096-

Home

(770) 623-4394

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade school

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. Manzo
Data Entry: D. Gomez