Pancho - COR-ALE-80

Code: COR-ALE-80
Mercy ID: V-02271-01
Encounter Date: 06/13/2006
Last: Cortez
First: Alejandra
DOB: 01/15/1980
County: Other
Street: 750 Six Flags Rd #405
City: Austell
State: GA

Zip

00000-

Home

(678) 508-5493

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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