Pancho - ROS-DIO-78

Code: ROS-DIO-78
Mercy ID: V-03244-01
Encounter Date: 01/27/2010
Last: Rosado
First: Diodelvina
DOB: 09/15/1978
County: Dekalb
Street: 1382 Northcliff Valley Way #-H
City: Atlanta
State: GA

Zip

30319-

Home

(404) 321-1840

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

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: YES
Relative: YES
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: YES

Intake: G. Landeros
Data Entry: J. Manzo