Pancho - MER-MAR-66

Code: MER-MAR-66
Mercy ID: V-00309-01
Encounter Date: 10/11/2000
Last: Mercado
First: Martha
DOB: 02/07/1966
County: Cobb
Street: Oak Street # 1746
City: Marietta
State: GA

Zip

30062-

Home

(678) 290-9443

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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. Manzo
Data Entry: D. Gomez