Pancho - AGU-ANA-70

Code: AGU-ANA-70
Mercy ID: V-02717-01
Encounter Date: 02/18/2008
Last: Anguiano
First: Ana
DOB: 08/14/1970
County: Gwinnett
Street: 2962 Deborat Road N.W.
City: Doraville
State: GA

Zip

30341-

Cell

(404) 525-1018

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: 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