Pancho - CON-ROS-73

Code: CON-ROS-73
Mercy ID: V-02787-01
Encounter Date: 05/16/2008
Last: Contreras
First: Rosa
DOB: 11/16/1973
County: Gwinnett
Street: 3257 Sunrise Village Ln. Apt. E
City: Norcross
State: GA

Zip

30093-

Cell

(404) 468-2420

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Single Family

Education Level

Child, not in 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: 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