Pancho - GUE-BER-69

Code: GUE-BER-69
Mercy ID: V-03450-01
Encounter Date: 11/08/2010
Last: Guevara
First: Berta
DOB: 09/28/1969
County: Dekalb
Street: 2561 New Bedford Ln. # F
City: Atlanta
State: GA

Zip

30319-

Cell

(404) 207-6534

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

Adult, no formal education

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: G. Landeros
Data Entry: J. Manzo