Pancho - COS-ARA-67

Code: COS-ARA-67
Mercy ID: V-01098-01
Encounter Date: 01/24/2003
Last: Coss
First: Araceli
DOB: 11/07/1967
County: Dekalb
Street: 1391 Northcliff Valley Way
City: Atlanta
State: GA

Zip

30319-

Home

(404) 486-0149

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Vocational/Technical

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. Perez
Data Entry: K. Aleman