Pancho - MOL-ARA-80

Code: MOL-ARA-80
Mercy ID: V-00304-01
Encounter Date: 10/04/2000
Last: Molina
First: Araceli
DOB: 04/28/1980
County: Gwinnett
Street: 5099 Victor Trail
City: Norcross
State: GA

Zip

30071-

Home

(770) 572-3219

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Other

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. Perez
Data Entry: K. Aleman