Pancho - ROD-EVA-74

Code: ROD-EVA-74
Mercy ID: V-03136-01
Encounter Date: 08/17/2009
Last: Rodriguez
First: Evangelina
DOB: 02/07/1974
County: Cobb
Street: 388 Phillips Dr.
City: Marietta
State: GA

Zip

30060-

Cell

(678) 663-7453

Family Status

Two parent family w/children

COB

USA

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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo