Pancho - DIA-ENE-44

Code: DIA-ENE-44
Mercy ID: V-00307-01
Encounter Date: 10/04/2000
Last: Diaz
First: Eneida
DOB: 07/24/1944
County: Dekalb
Street: 4304 winter chapel rd
City: Doraville
State: GA

Zip

30360-

Home

(770) 248-1631

Family Status

Two parent family w/children

COB

Colombia

Gender

Female

Housing

Doubling Up

Education Level

Some College

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. Manzo
Data Entry: S. Aviña