Pancho - CAS-MAT-62

Code: CAS-MAT-62
Mercy ID: V-00292-01
Encounter Date: 09/25/2000
Last: Castillo
First: Marta
DOB: 05/18/1962
County: Cobb
Street: 4650 Rambling Rd
City: Kenne
State: GA

Zip

30144-

Home

(770) 592-5350

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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. Manzo
Data Entry: D. Gomez