Pancho - KEY-ANN-74

Code: KEY-ANN-74
Mercy ID: V-02165-01
Encounter Date: 02/14/2006
Last: Key
First: Anna
DOB: 10/08/1974
County: Fulton
Street: 3210 Matheson Dr
City: Atlanta
State: GA

Zip

30305-

Home

(404) 846-8224

Family Status

Two parent family w/children

COB

USA

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: G. Landeros
Data Entry: R. Gonzalez