Pancho - GUT-ROC-79

Code: GUT-ROC-79
Mercy ID: V-02205-01
Encounter Date: 03/22/2006
Last: Gutierrez
First: Rocio
DOB: 08/12/1979
County: Gwinnett
Street: 2606 Park Colony Dr
City: Norcross
State: GA

Zip

30093-

Home

(770) 491-0412

Family Status

Two parent family 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: 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