Pancho - VEL-ANG-78

Code: VEL-ANG-78
Mercy ID: V-00582-01
Encounter Date: 11/20/2001
Last: Velasquez
First: Angela
DOB: 10/02/1978
County: Cobb
Street: 6771 Landmarck Way 14-C
City: Austell
State: GA

Zip

30168-

Home

(770) 944-1780

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

some high school

Home Owner

YES

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