Pancho - NAM-TEO-78

Code: NAM-TEO-78
Mercy ID: V-03350-01
Encounter Date: 06/23/2010
Last: Nambo
First: Teodora
DOB: 12/27/1978
County: Gwinnett
Street: 1021 Rockbridge Rd.
City: Norcross
State: GA

Zip

30093-

Cell

(678) 634-2919

Family Status

Child/Youth

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade 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: 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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo