Pancho - CRU-ROG-54

Code: CRU-ROG-54
Mercy ID: V-00982-01
Encounter Date: 07/31/2002
Last: Cruz
First: Rogelia
DOB: 04/08/1954
County: Fulton
Street: 4558 Roswell Rd. Apt. K4
City: Roswell
State: GA

Zip

30342-

Home

(404) 257-1730

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: 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. Perez
Data Entry: K. Aleman