Pancho - DEL-MAR-80

Code: DEL-MAR-80
Mercy ID: V-03355-01
Encounter Date: 07/06/2010
Last: De la osa
First: Mariela
DOB: 05/12/1980
County: Gwinnett
Street: 4235 Woodwing Road
City: Norcross
State: GA

Zip

30044-

Cell

(678) 559-1812

Family Status

Adult couple-no children

COB

Colombia

Gender

Female

Housing

Single Family

Education Level

Some College

Home Owner

YES

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