Pancho - NAV-MAR-64

Code: NAV-MAR-64
Mercy ID: V-00256-01
Encounter Date: 07/26/2000
Last: Nava
First: Margarita
DOB: 08/17/1964
County: Gwinnett
Street: 5376 Stanford Village Ln
City: Norcross
State: GA

Zip

30071-

Home

(678) 458-8068

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Other

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: Y. Garcia