Pancho - TIR-MAR-76

Code: TIR-MAR-76
Mercy ID: V-02616-01
Encounter Date: 10/10/2007
Last: Tirado
First: Maria milagros
DOB: 06/15/1976
County: Gwinnett
Street: 5165 Harbins Point Lan NW
City: Lilburn
State: GA

Zip

30047-

Cell

(404) 933-6042

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: 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