Pancho - FOW-BRA-82

Code: FOW-BRA-82
Mercy ID: V-01386-01
Encounter Date: 10/14/2003
Last: Fowler
First: Brandie
DOB: 01/23/1982
County: Fulton
Street: 2787 Chewey St.
City: East point
State: GA

Zip

30344-

Home

(678) 755-9491

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high school

Home Owner

YES

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