Pancho - VAR-FAB-75

Code: VAR-FAB-75
Mercy ID: V-02544-01
Encounter Date: 07/13/2007
Last: Varela
First: Faviola
DOB: 04/25/1975
County: Dekalb
Street: 3118 Buford Hwy # 14
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 604-7891

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Transitional

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: 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