Pancho - SER-DIN-86

Code: SER-DIN-86
Mercy ID: V-03429-01
Encounter Date: 09/22/2010
Last: Serna
First: Dina
DOB: 02/08/1986
County: Gwinnett
Street: 3479 Dianthus
City: Larenceville
State: GA

Zip

30044-

Cell

(678) 994-3563

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

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: J. Perez
Data Entry: J. Manzo