Pancho - DAY-MAR-54

Code: DAY-MAR-54
Mercy ID: V-01731-01
Encounter Date: 10/19/2004
Last: Day
First: Marta cecilia
DOB: 05/27/1954
County: Gwinnett
Street: 3942 Hooch Landing
City: Duluth
State: GA

Zip

30097-

Home

(770) 622-3882

Cell

(423) 544-9262

Family Status

Single adult

COB

Colombia

Gender

Female

Housing

Transitional

Education Level

College Degree

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: No
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