Pancho - DIA-ARA-75

Code: DIA-ARA-75
Mercy ID: V-02398-01
Encounter Date: 01/23/2007
Last: Diaz
First: Araceli
DOB: 07/31/1975
County: Hall
Street: 5216 Ramble Train Lot 141
City: Buford
State: GA

Zip

30518-

Home

(678) 546-6348

Cell

(678) 255-5101

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

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: J. Manzo