Pancho - CAR-BEI-76

Code: CAR-BEI-76
Mercy ID: V-02270-01
Encounter Date: 06/13/2006
Last: Carranza
First: Beisy
DOB: 02/26/1976
County: Gwinnett
Street: 659 South Wind Dr
City: Lilburn
State: GA

Zip

30047-

Home

(678) 665-5168

Family Status

Two parent family w/children

COB

Honduras

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