Pancho - VEL-JUL-54

Code: VEL-JUL-54
Mercy ID: V-01458-01
Encounter Date: 01/05/2004
Last: Velasquez
First: Julia
DOB: 07/30/1954
County: Fulton
Street: 1479 Raintree Dr. Apt H
City: Roswell
State: GA

Zip

30076-

Home

(770) 643-0185

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. Manzo
Data Entry: K. Aleman