Pancho - GON-CAR-62

Code: GON-CAR-62
Mercy ID: V-00281-01
Encounter Date: 09/05/2000
Last: Gonzalez
First: Carmelita
DOB: 10/10/1962
County: Dekalb
Street: 4729 Buford Hwy Apt. h
City: Chamblee
State: GA

Zip

30341-

Home

(770) 216-9932

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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