Pancho - SAN-LET-79

Code: SAN-LET-79
Mercy ID: V-01419-01
Encounter Date: 11/19/2003
Last: Sanchez vilchis
First: Leticia
DOB: 10/07/1979
County: Forsyth
Street: 311 Maple St.
City: Cumming
State: GA

Zip

30040-

Home

(678) 513-6973

Family Status

Single adult

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: 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