Pancho - AGU-DOL-87

Code: AGU-DOL-87
Mercy ID: V-03257-01
Encounter Date: 02/10/2010
Last: Aguilera
First: Doris
DOB: 10/20/1987
County: Other
Street: 221 Hunon St.
City: Fayetteville
State: NC

Zip

28303-

Cell

(404) 819-9017

Family Status

Single parent w/children

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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