Pancho - ESC-ELU-74

Code: ESC-ELU-74
Mercy ID: V-02226-01
Encounter Date: 04/06/2006
Last: Escalante
First: Elvia
DOB: 06/30/1974
County: Dekalb
Street: not given
City: Chamblee
State: GA

Zip

30341-

Home

(770) 220-0731

Family Status

Single parent w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

Adult, no formal education

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