Pancho - GON-JUD-77

Code: GON-JUD-77
Mercy ID: V-02175-01
Encounter Date: 02/23/2006
Last: Gonzalez
First: Yudith
DOB: 08/23/1977
County: Henry
Street: 203 Autumn Lake Way
City: Mcdonald
State: GA

Zip

30253-

Cell

(678) 760-4739

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Not Homeless

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