Pancho - ADA-ERI-74

Code: ADA-ERI-74
Mercy ID: V-01099-01
Encounter Date: 01/31/2003
Last: Adame
First: Erika
DOB: 10/07/1973
County: Gwinnett
Street: 9940 National Circle Apt. A
City: Tucker
State: GA

Zip

30084-

Home

(770) 374-4794

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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