Pancho - SIE-YES-74

Code: SIE-YES-74
Mercy ID: V-00921-01
Encounter Date: 05/07/2002
Last: Sierra
First: Yesenia
DOB: 10/22/1974
County: Dekalb
Street: 4900 Central Dr.
City: Stone mountain
State: GA

Zip

30083-

Home

(770) 879-5246

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Not Homeless

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