Pancho - VAZ-ERI-75

Code: VAZ-ERI-75
Mercy ID: V-01093-01
Encounter Date: 01/22/2003
Last: Vazquez
First: Erika
DOB: 06/17/1975
County: Fulton
Street: 3375 Aztec Dr. Apt. 42
City: Doraville
State: GA

Zip

30340-

Home

(770) 986-4118

Family Status

Single parent 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