Pancho - VEG-ISR-60

Code: VEG-ISR-60
Mercy ID: V-02858-01
Encounter Date: 07/23/2008
Last: Vega
First: Israela
DOB: 03/09/1960
County: Wayne
Street: 255 Pine Street Road
City: Jesup
State: GA

Zip

31545-

Cell

(319) 528-1630

Family Status

Two parent family w/children

COB

Cuba

Gender

Female

Housing

Single Family

Education Level

High school graduate

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