Pancho - AMB-BER-84

Code: AMB-BER-84
Mercy ID: V-02170-01
Encounter Date: 02/16/2006
Last: Ambrocio
First: Berenice
DOB: 08/22/1984
County: Dekalb
Street: 3585 Buford Hwy Apt-6
City: Atlanta
State: GA

Zip

30329-

Cell

(678) 791-2991

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