Pancho - RAY-CLA-76

Code: RAY-CLA-76
Mercy ID: V-01072-01
Encounter Date: 01/08/2003
Last: Rayo
First: Clara
DOB: 09/18/1976
County: Dekalb
Street: 1368 N. Cliff Valley Way G4
City: Atlanta
State: GA

Zip

30319-

Home

(404) 321-0575

Family Status

Two parent family w/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: 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