Pancho - BAC-GRI-64

Code: BAC-GRI-64
Mercy ID: V-01671-01
Encounter Date: 08/12/2004
Last: Baca
First: Griselda
DOB: 11/26/1964
County: Rockdale
Street: 68 Magnolia
City: Conyers
State: GA

Zip

30012-

Home

(770) 922-1416

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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