Pancho - CAS-SUS-57

Code: CAS-SUS-57
Mercy ID: V-01641-01
Encounter Date: 06/30/2004
Last: Castillo
First: Susana
DOB: 11/12/1957
County: Dekalb
Street: 3600 Shallowford Apt B-7
City: Chamblee
State: GA

Zip

30341-

Home

(770) 216-8467

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: YES
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