Pancho - DIA-VAL-81

Code: DIA-VAL-81
Mercy ID: V-01038-01
Encounter Date: 11/13/2002
Last: Diaz
First: Valentina
DOB: 03/07/1981
County: Dekalb
Street: 1514 Peachtree Industrial Blvd
City: Doraville
State: GA

Zip

30341-

Home

(404) 246-5610

Family Status

Single adult

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