Pancho - HRR-MAR-74

Code: HRR-MAR-74
Mercy ID: V-02545-01
Encounter Date: 07/11/2007
Last: Herrera
First: Martha
DOB: 01/22/1974
County: Dekalb
Street: 2935 North Dekalb
City: Doraville
State: GA

Zip

30340-

Home

(770) 235-8355

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Preschool

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