Pancho - BAR-YES-80

Code: BAR-YES-80
Mercy ID: V-03072-01
Encounter Date: 05/13/2009
Last: Barajas
First: Yesenia
DOB: 02/07/1980
County: Clayton
Street: 6355 Valley Dale Road
City: Riverdale
State: GA

Zip

30274-

Cell

(678) 368-6568

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade school

Home Owner

YES

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: YES
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