Pancho - PIÑ-ELI-84

Code: PIÑ-ELI-84
Mercy ID: V-00655-01
Encounter Date: 08/23/2001
Last: Piña
First: Elizabeth
DOB: 07/12/1984
County: Dekalb
Street: 1034 Franklin Rd
City: Marietta
State: GA

Zip

30067-

Home

(770) 794-9161

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: 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