Pancho - GAR-MAU-75

Code: GAR-MAU-75
Mercy ID: V-02913-01
Encounter Date: 10/15/2008
Last: Garcia
First: Maure
DOB: 07/13/1976
County: Fulton
Street: 7829 Midway Road
City: Alpharetta
State: GA

Zip

30004-

Home

(678) 947-6016

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade 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