Pancho - CRU-GEO-68

Code: CRU-GEO-68
Mercy ID: V-01150-01
Encounter Date: 03/10/2003
Last: Cruz
First: Georgina
DOB: 05/10/1968
County: Dekalb
Street: 3008 Winspring Hill
City: Chamblee
State: GA

Zip

30341-

Home

(770) 451-0965

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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. Perez
Data Entry: K. Aleman