Pancho - ROD-ILS-77

Code: ROD-ILS-77
Mercy ID: V-02436-01
Encounter Date: 03/12/2007
Last: Rodriguez
First: Ilsy
DOB: 11/24/1977
County: Gwinnett
Street: 6234 Forest Valley k-5
City: Norcoss
State: GA

Zip

30093-

Home

(678) 380-3922

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Not Homeless

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: C. Martinez