Pancho - HUR-MAR-61

Code: HUR-MAR-61
Mercy ID: V-00404-01
Encounter Date: 01/31/2001
Last: Hurtado
First: Maria
DOB: 11/24/1961
County: Cobb
Street: 1150 Atlanta Rd Lt 106
City: Marietta
State: GA

Zip

30060-

Home

(770) 428-0662

Family Status

Two parent family w/children

COB

Nicaragua

Gender

Female

Housing

Not Homeless

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: D. Gomez