Pancho - MOR-SIL-73

Code: MOR-SIL-73
Mercy ID: V-02987-01
Encounter Date: 01/14/2009
Last: Moran
First: Silvia
DOB: 04/19/1973
County: Dekalb
Street: 4920 Winter Chapel Rd. # M-5
City: Ddoraville
State: GA

Zip

30360-

Cell

(678) 663-6822

Family Status

Single adult

COB

USA-Ecuador

Gender

Female

Housing

Doubling Up

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