Pancho - GAR-LET-84

Code: GAR-LET-84
Mercy ID: V-02911-01
Encounter Date: 10/13/2008
Last: Garcia
First: Leticia
DOB: 03/25/1984
County: Gwinnett
Street: 306 Club lakes Pkwy
City: Lawrenceville
State: GA

Zip

30044-

Cell

(678) 254-8715

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

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