Pancho - VID-ALB-76

Code: VID-ALB-76
Mercy ID: V-01251-01
Encounter Date: 06/17/2003
Last: Vides
First: Alba
DOB: 11/05/1976
County: Gwinnett
Street: 5044 Cherokee Ct.
City: Norcross
State: GA

Zip

30071-

Home

(404) 454-6432

Family Status

Two parent family w/children

COB

Guatemala

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: 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