Pancho - ROD-FRA-78

Code: ROD-FRA-78
Mercy ID: V-01160-01
Encounter Date: 03/14/2003
Last: Rodriguez
First: Francisca
DOB: 11/29/1978
County: Gwinnett
Street: 000 Some Street
City: Lilburn
State: GA

Zip

30047-

Home

(770) 931-0370

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Other

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