Pancho - GON-MAR-68

Code: GON-MAR-68
Mercy ID: V-02841-01
Encounter Date: 07/03/2008
Last: Gonzalez
First: Mariela
DOB: 08/29/1968
County: Gwinnett
Street: 229 Kylman
City: Lilburn
State: GA

Zip

30047-

Cell

(404) 246-2942

Family Status

Two parent family w/children

COB

Chile

Gender

Female

Housing

Single Family

Education Level

College Degree

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: J. Perez
Data Entry: J. Manzo