Pancho - TAR-SIL-70

Code: TAR-SIL-70
Mercy ID: V-00362-01
Encounter Date: 12/05/2000
Last: Tarango
First: Silvia
DOB: 05/19/1970
County: Cobb
Street: 1260 South Cobb Dr. Lt. 51
City: Marietta
State: GA

Zip

30060-

Cell

(678) 914-3410

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Single Family

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. Perez
Data Entry: S. Aviña