Pancho - CAR-JAN-60

Code: CAR-JAN-60
Mercy ID: V-03455-01
Encounter Date: 10/29/2010
Last: Cardin
First: Janeth
DOB: 11/22/1960
County: Gwinnett
Street: 3028 Merrion Park
City: Dacula
State: GA

Zip

30019-

Cell

(770) 375-0841

Family Status

Two parent family w/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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo