Pancho - DEN-SAR-61

Code: DEN-SAR-61
Mercy ID: V-00705-01
Encounter Date: 09/28/2001
Last: Denham
First: Sara
DOB: 07/22/1961
County: Other
Street: 2390 Fairburn Rd. Lot 158
City: Douglassville
State: GA

Zip

30135-

Home

(770) 577-4127

Family Status

Adult coupie-no children

COB

Colombia

Gender

Female

Housing

Not Homeless

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: 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. Manzo
Data Entry: K. Aleman