Pancho - RAN-GIS-79

Code: RAN-GIS-79
Mercy ID: V-01742-01
Encounter Date: 10/26/2004
Last: Rangel
First: Maria gisela
DOB: 04/25/1979
County: Gwinnett
Street: 1578 Roman Point Dr.
City: Norcross
State: GA

Zip

30093-

Home

(404) 437-0732

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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: 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. Perez
Data Entry: K. Aleman