Pancho - PIM-VAL-58

Code: PIM-VAL-58
Mercy ID: V-00250-01
Encounter Date: 07/19/2000
Last: Pimentel
First: Valentina
DOB: 07/21/1958
County: Dekalb
Street: 1225 Kelton Dr
City: Stone mountain
State: GA

Zip

30383-

Home

(404) 296-3270

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: J. Perez
Data Entry: D. Gomez