Pancho - GAR-MAR-77

Code: GAR-MAR-77
Mercy ID: V-00363-01
Encounter Date: 12/13/2000
Last: Garcia
First: Maria elena
DOB: 04/16/1977
County: Dekalb
Street: 2462 Ortega Way
City: Chamblee
State: GA

Zip

30341-

Home

(404) 444-4884

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: Y. Garcia