Pancho - VAL-RAQ-75

Code: VAL-RAQ-75
Mercy ID: V-00904-01
Encounter Date: 04/04/2002
Last: Valdez
First: Raquel
DOB: 10/22/1975
County: Dekalb
Street: 3028 Chamblee Tucker Rd. #106
City: Chamblee
State: GA

Zip

30314-

Home

(770) 234-0211

Family Status

Adult coupie-no 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