Pancho - GAL-ANA-54

Code: GAL-ANA-54
Mercy ID: V-00664-01
Encounter Date: 09/04/2001
Last: Galeas
First: Ana rosa
DOB: 07/26/1954
County: Gwinnett
Street: 1893 Guardian Way
City: Lawrenceville
State: GA

Zip

30343-

Home

(678) 377-3072

Family Status

Two parent family w/children

COB

Honduras

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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. Manzo
Data Entry: K. Aleman