Pancho - GON-ANM-74

Code: GON-ANM-74
Mercy ID: V-02864-01
Encounter Date: 08/04/2008
Last: Gonzalez
First: Ana maria
DOB: 09/02/1974
County: Gwinnett
Street: 2020 Applen Rich
City: Sugar hill
State: GA

Zip

30158-

Cell

(678) 887-2773

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Single Family

Education Level

Grade 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: J. Perez
Data Entry: J. Manzo