Pancho - SAL-INE-69

Code: SAL-INE-69
Mercy ID: V-01085-01
Encounter Date: 01/22/2003
Last: Salgado
First: Ines
DOB: 01/21/1969
County: Gwinnett
Street: 3525 Club Dr. Apt. 513
City: Lawrenceville
State: GA

Zip

30044-

Home

(678) 380-9887

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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