Pancho - SAN-JUA-80

Code: SAN-JUA-80
Mercy ID: V-01447-01
Encounter Date: 12/29/2003
Last: Sanchez
First: Juana
DOB: 05/07/1980
County: Cherokee
Street: 6359 Bells Ferry Rd. Lot 296
City: Ackworth
State: GA

Zip

30102-

Home

(678) 494-0383

Family Status

Single parent w/children

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. Manzo
Data Entry: K. Aleman