Pancho - SOR-ROS-79

Code: SOR-ROS-79
Mercy ID: V-03184-01
Encounter Date: 10/13/2009
Last: Sorto
First: Rosaibel
DOB: 09/20/1979
County: Gwinnett
Street: 5207 Secretaria Court
City: Norcross
State: GA

Zip

30093-

Cell

(678) 789-0524

Family Status

Two parent family w/children

COB

El Salvador

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