Pancho - VAZ-ESL-82

Code: VAZ-ESL-82
Mercy ID: V-03272-01
Encounter Date: 03/08/2010
Last: Vazquez
First: Esly
DOB: 07/31/1982
County: Cherokee
Street: 999 Shelter
City: Canton
State: GA

Zip

30114-

Cell

(770) 479-1809

Family Status

Single parent w/children

COB

Honduras

Gender

Female

Housing

Shelter

Education Level

Other

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