Pancho - DYM-NAT-78

Code: DYM-NAT-78
Mercy ID: V-02895-01
Encounter Date: 09/24/2008
Last: Dymant
First: Natalia
DOB: 11/09/1978
County: Forsyth
Street: 7125 Jonesway Road
City: Cumming
State: GA

Zip

30041-

Cell

(404) 290-9919

Family Status

Two parent family w/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: 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: G. Landeros
Data Entry: J. Manzo