Pancho - ZAM-ILE-55

Code: ZAM-ILE-55
Mercy ID: V-02683-01
Encounter Date: 12/18/2007
Last: Zamora
First: Ileana
DOB: 04/11/1955
County: Henry
Street: 145 Whistle Way
City: Locust grove
State: GA

Zip

30248-

Home

(770) 288-2941

Family Status

Two parent family w/children

COB

Nicaragua

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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