Pancho - CRU-CEC-75

Code: CRU-CEC-75
Mercy ID: V-03325-01
Encounter Date: 05/14/2010
Last: Cruz
First: Cecilia
DOB: 11/22/1975
County: Gwinnett
Street: 3752 Guthrir Cr.
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 885-0896

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: 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