Pancho - PER-SAN-73

Code: PER-SAN-73
Mercy ID: V-00245-01
Encounter Date: 06/28/2000
Last: Niño
First: Sandra
DOB: 06/13/1973
County: Cobb
Street: 660 Foot Path Lane
City: Marietta
State: GA

Zip

30062-

Cell

(678) 650-2719

Family Status

Single parent 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: J. Perez
Data Entry: K. Aleman