Pancho - MAR-ISA-83

Code: MAR-ISA-83
Mercy ID: V-02266-01
Encounter Date: 06/09/2006
Last: Martines
First: Isabel
DOB: 05/13/1983
County: Other
Street: 1512 Hwy 85 West #45A
City: Fayetteville
State: GA

Zip

30240-

Cell

(770) 719-3924

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Other

Education Level

High school graduate

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