Pancho - GAR-MRI-78

Code: GAR-MRI-78
Mercy ID: V-02563-01
Encounter Date: 08/13/2007
Last: Garcia
First: Maria angelica
DOB: 07/11/1978
County: Fulton
Street: 1414 Summitt Place Rd.
City: Atlanta
State: GA

Zip

30350-

Cell

(678) 596-4119

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: G. Landeros
Data Entry: J. Manzo