Pancho - BET-LET-78

Code: BET-LET-78
Mercy ID: V-02256-01
Encounter Date: 05/24/2006
Last: Betancourt
First: Leticia
DOB: 09/14/1978
County: Cobb
Street: 2078 Cherokee Ridge Trl
City: Kennesaw
State: GA

Zip

30144-

Home

(770) 514-7684

Cell

(678) 895-2439

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: 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