Pancho - DEM-ANG-75

Code: DEM-ANG-75
Mercy ID: V-01516-01
Encounter Date: 03/03/2004
Last: De mozo
First: Angela
DOB: 02/23/1975
County: Fulton
Street: Not given
City: Not given
State: GA

Zip

00000-0000

Home

(770) 270-1791

Family Status

Single parent w/children

COB

El Salvador

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