Pancho - VIL-TER-70

Code: VIL-TER-70
Mercy ID: V-02603-01
Encounter Date: 09/28/2007
Last: Villegas
First: Teresa
DOB: 10/12/1970
County: Dekalb
Street: 5102 Evans Road # 12
City: Chamblee
State: GA

Zip

30341-

Cell

(678) 438-3611

Family Status

Adult couple-no children

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

Some College

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