Pancho - DEL-MAR-59

Code: DEL-MAR-59
Mercy ID: V-01033-01
Encounter Date: 11/13/2002
Last: De la cruz
First: Maria del carmen
DOB: 06/29/1959
County: Gwinnett
Street: 1870 Atlanta Rd. Apt. D7
City: Smyrna
State: GA

Zip

30080-

Home

(770) 319-8463

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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