Pancho - RIN-SAN-80

Code: RIN-SAN-80
Mercy ID: V-01348-01
Encounter Date: 09/15/2003
Last: Rincon
First: Sandra
DOB: 09/11/1980
County: Not given
Street: 450 Peachtree Parkway C-301
City: Peachtree city
State: GA

Zip

30269-

Home

(770) 487-6863

Family Status

Single parent 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: 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: K. Aleman