Pancho - CER-MAR-48

Code: CER-MAR-48
Mercy ID: V-02604-01
Encounter Date: 08/22/2007
Last: Cervantes
First: Maria del socorro
DOB: 03/17/1948
County: Fulton
Street: 13016 Gardner Dr.
City: Alpharetta
State: GA

Zip

30004-

Cell

(678) 549-6463

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Other

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