Pancho - MAR-GUD-76

Code: MAR-GUD-76
Mercy ID: V-02420-01
Encounter Date: 02/26/2007
Last: Martinez
First: Gudelia
DOB: 07/13/1976
County: Gwinnett
Street: 1355 Gawes Rd. # 119
City: Norcross
State: GA

Zip

30093-

Cell

(678) 791-2086

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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: 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: J. Manzo