Pancho - CAR-JOV-73

Code: CAR-JOV-73
Mercy ID: V-01220-01
Encounter Date: 10/03/2003
Last: Carrranza
First: Jovita
DOB: 08/04/1973
County: Cobb
Street: 1821 Killarney Dr.
City: Marietta
State: GA

Zip

30008-

Home

(770) 636-5735

Family Status

Two parent family 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: YES
Stranger: YES
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