Pancho - AGU-GUA-68

Code: AGU-GUA-68
Mercy ID: V-00224-01
Encounter Date: 05/24/2000
Last: Aguirre
First: Guadalupe
DOB: 05/21/1968
County: Fulton
Street: 1505 Chatahochee Dr.
City: Atlanta
State: GA

Zip

30318-

Home

(404) 351-6914

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Manzo
Data Entry: K. Aleman