Pancho - HIP-ELE-46

Code: HIP-ELE-46
Mercy ID: V-02677-01
Encounter Date: 12/13/2007
Last: Hipolito
First: Elena
DOB: 10/26/1946
County: Newton
Street: 2277 Christian Cir. S.E.
City: Conyers
State: GA

Zip

30013-

Cell

(404) 723-6075

Family Status

Single adult

COB

Cuba

Gender

Female

Housing

Single Family

Education Level

some high 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