Pancho - HUE-VIC-78

Code: HUE-VIC-78
Mercy ID: V-03515-01
Encounter Date: 01/25/2011
Last: Huerta
First: Victoria
DOB: 01/11/1978
County: Dekalb
Street: 4633 Peachtree Place Parkway
City: Doraville
State: GA

Zip

30360-

Cell

(678) 914-5418

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

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