Pancho - MEN-HAY-85

Code: MEN-HAY-85
Mercy ID: V-03255-01
Encounter Date: 02/09/2010
Last: Mendivil
First: Haylin
DOB: 12/03/1985
County: Newton
Street: 360 Lakeside Point
City: Covington
State: GA

Zip

30016-

Cell

(770) 728-3589

Family Status

Adult couple-no children

COB

Colombia

Gender

Female

Housing

Doubling Up

Education Level

Vocational/Technical

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: J. Manzo