Pancho - MAR-ANA-81

Code: MAR-ANA-81
Mercy ID: V-03009-01
Encounter Date: 02/17/2009
Last: Martinez
First: Ana laura
DOB: 12/06/1981
County: Dekalb
Street: 3536 Pleasantbrook Village # B
City: Doraville
State: GA

Zip

30340-

Cell

(678) 368-5738

Family Status

Single parent w/children

COB

Mexico

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