Pancho - CRU-SAN-93

Code: CRU-SAN-93
Mercy ID: V-03377-01
Encounter Date: 07/17/2010
Last: Cruz
First: Sandra
DOB: 03/29/1993
County: Dekalb
Street: 999 NO LA SABE
City: Atlanta
State: GA

Zip

30345-

Cell

(678) 886-3638

Family Status

Single adult

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

some high school

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: 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