Pancho - LEO-BEA-83

Code: LEO-BEA-83
Mercy ID: V-03214-01
Encounter Date: 11/18/2009
Last: Leon
First: Beatriz
DOB: 03/13/1983
County: Clayton
Street: 1409 Rockut Road
City: Forest park
State: GA

Zip

30297-

Cell

(404) 293-4841

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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

Intake: J. Perez
Data Entry: C. Collier