Pancho - BOT-BLA-61

Code: BOT-BLA-61
Mercy ID: V-00381-01
Encounter Date: 01/08/2001
Last: Boteo
First: Blanca
DOB: 04/28/1961
County: Cobb
Street: 2121 Windy Hill Rd. Apt 1841
City: Marietta
State: GA

Zip

30070-

Home

(770) 438-6591

Family Status

Two parent family w/children

COB

Costa Rica

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: YES
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: K. Aleman