Pancho - AVE-ANA-65

Code: AVE-ANA-65
Mercy ID: V-01008-01
Encounter Date: 09/04/2002
Last: Avelar
First: Ana
DOB: 06/23/1965
County: Gwinnett
Street: 2304 Ranch Trail
City: Norcross
State: GA

Zip

30071-

Home

(678) 969-0845

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: 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