Pancho - PUL-GEO-54

Code: PUL-GEO-54
Mercy ID: V-00476-01
Encounter Date: 04/13/2001
Last: Pulido
First: Georgina
DOB: 10/28/1954
County: Cobb
Street: 1725 Darwin Rd. Apt. 3
City: Smyrna
State: GA

Zip

30080-

Home

(678) 575-9159

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Vocational/Technical

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. Perez
Data Entry: K. Aleman