Pancho - AGU-DIN-54

Code: AGU-DIN-54
Mercy ID: V-02743-01
Encounter Date: 03/26/2008
Last: Aguila
First: Dinorah
DOB: 09/10/1954
County: Fulton
Street: 1490 Steltren Way
City: Alpharetta
State: GA

Zip

30004-

Cell

(678) 886-1756

Family Status

Two parent family w/children

COB

El Salvador

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: G. Landeros
Data Entry: J. Manzo