Pancho - LAR-DEL-86

Code: LAR-DEL-86
Mercy ID: V-03459-01
Encounter Date: 11/03/2010
Last: Lara
First: Delia
DOB: 07/08/1986
County: Gwinnett
Street: 999 NO LO QUISO DAR
City: Buford
State: GA

Zip

30519-

Cell

(404) 246-1096

Family Status

Two parent family w/children

COB

Honduras

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: G. Landeros
Data Entry: J. Manzo