Pancho - VEG-REY-76

Code: VEG-REY-76
Mercy ID: V-00060-01
Encounter Date: 01/19/2000
Last: Vega
First: Reyna
DOB: 11/01/1976
County: Fulton
Street: 706 bellcourt parkway apt 706
City: Roswell
State: GA

Zip

30076-

Home

(770) 650-9533

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Preschool

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: S. Aviña