Pancho - VAR-ROS-47

Code: VAR-ROS-47
Mercy ID: V-01047-01
Encounter Date: 10/11/2002
Last: Varela
First: Rosa
DOB: 08/19/1947
County: Fulton
Street: 1381 Custer Ave. A-6
City: Atlanta
State: GA

Zip

30316-

Home

(678) 754-1954

Family Status

Adult coupie-no children

COB

Nicaragua

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. Manzo
Data Entry: K. Aleman