Pancho - ESP-JEN-62

Code: ESP-JEN-62
Mercy ID: V-02631-01
Encounter Date: 05/18/2009
Last: Espinoza
First: Jenny
DOB: 06/13/1962
County: Gwinnett
Street: 2525 N. Crestview Drivw
City: Grayson
State: GA

Zip

30017-

Cell

(678) 770-3687

Family Status

Adult couple-no children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade school

Home Owner

YES

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: J. Perez
Data Entry: J. Manzo