Pancho - VAR-CRI-82

Code: VAR-CRI-82
Mercy ID: V-01760-01
Encounter Date: 11/29/2004
Last: Vargas
First: Cristina
DOB: 08/04/1982
County: Cobb
Street: 1901 Old Concord Rd. Apt M8
City: Smyrna
State: GA

Zip

30080-

Home

(770) 438-7875

Family Status

Two parent family w/children

COB

Mexico

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. Manzo
Data Entry: K. Aleman