Pancho - ANG-MAR-68

Code: ANG-MAR-68
Mercy ID: B-00002-01
Encounter Date: 02/11/1998
Last: Angel
First: Maria
DOB: 09/08/1968
County: Cobb
Street: 1555 A Oak Pointe Dr.
City: Marietta
State: GA

Zip

30008-

Home

(770) 438-8497

Cell

(678) 355-1153

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Other

Education Level

High school graduate

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. Perez
Data Entry: K. Aleman