Pancho - MAR-JOS-66

Code: MAR-JOS-66
Mercy ID: V-00248-01
Encounter Date: 07/18/2000
Last: Martinez
First: Josefina
DOB: 03/19/1966
County: Fulton
Street: 5140 Jonesboro Rd.
City: Union city
State: GA

Zip

30291-

Home

(770) 306-8192

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade school

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: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: K. Aleman