Pancho - FRI-SUS-62

Code: FRI-SUS-62
Mercy ID: V-02774-01
Encounter Date: 05/02/2008
Last: Fritschi
First: Susana
DOB: 11/12/1962
County: Gwinnett
Street: 2410 Coweta Road
City: Dacula
State: GA

Zip

30019-

Cell

(678) 851-0748

Family Status

Adult couple-no children

COB

Uruguay

Gender

Female

Housing

Doubling Up

Education Level

some high 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