Pancho - SCO-MAR-72

Code: SCO-MAR-72
Mercy ID: V-03471-01
Encounter Date: 10/25/2010
Last: Scott
First: Maria isabel
DOB: 01/08/1972
County: Douglass
Street: 2516 Jonesbrook Road
City: Lithia spring
State: GA

Zip

30122-

Cell

(404) 879-8556

Family Status

Adult couple-no 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: 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