Pancho - MES-SIL-61

Code: MES-SIL-61
Mercy ID: V-02280-01
Encounter Date: 06/26/2006
Last: Mesa
First: Silvia
DOB: 07/28/1961
County: Clayton
Street: Tara Blvd #K5
City: Jonesboro
State: GA

Zip

30236-

Cell

(678) 768-0765

Family Status

Single parent w/children

COB

Uruguay

Gender

Female

Housing

Not Homeless

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