Pancho - AND-ALI-71

Code: AND-ALI-71
Mercy ID: V-02475-01
Encounter Date: 04/23/2007
Last: Andrade
First: Alicia
DOB: 02/02/1971
County: Gwinnett
Street: 4955 Northinglane
City: Snellville
State: GA

Zip

30039-

Cell

(404) 604-6431

Family Status

Two parent family w/children

COB

Honduras

Gender

Female

Housing

Not Homeless

Education Level

some high 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: J. Perez
Data Entry: J. Manzo