Pancho - ABA-MAR-69

Code: ABA-MAR-69
Mercy ID: B-00035-01
Encounter Date: 09/08/1995
Last: Aguilera
First: Maria
DOB: 06/12/1969
County: Other
Street: Unknown
City: Unknown
State: GA

Zip

00000-0000

Home

(404) 635-1811

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

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: J. Manzo
Data Entry: K. Aleman