Pancho - NAC-NAN-53

Code: NAC-NAN-53
Mercy ID: V-02914-01
Encounter Date: 10/13/2008
Last: Nacara
First: Nancy
DOB: 07/17/1953
County: Fulton
Street: 3585 Apple Circle Road
City: Riverdale
State: GA

Zip

30296-

Cell

(305) 409-7463

Family Status

Single adult

COB

Colombia

Gender

Female

Housing

Doubling Up

Education Level

Post Grad Degree

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