Pancho - BIB-CAN-76

Code: BIB-CAN-76
Mercy ID: V-02193-01
Encounter Date: 03/14/2006
Last: Bibiano
First: Candelaria
DOB: 02/02/1976
County: Dekalb
Street: 3106 Buford Hwy E
City: Atlanta
State: GA

Zip

30329-

Home

(404) 521-3500

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Other

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: G. Landeros
Data Entry: R. Gonzalez