Pancho - SAG-MAR-73

Code: SAG-MAR-73
Mercy ID: V-02946-01
Encounter Date: 11/17/2008
Last: Salgado
First: Maria
DOB: 06/06/1973
County: Clayton
Street: 604 North Ave.
City: Forest park
State: GA

Zip

30297-

Cell

(404) 707-4015

Family Status

Single parent 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