Pancho - BOL-MAR-51

Code: BOL-MAR-51
Mercy ID: V-01786-01
Encounter Date: 12/16/2004
Last: Bolaños
First: Maria
DOB: 03/08/1951
County: Gwinnett
Street: 902 Willow Tr. Dr.
City: Norcross
State: GA

Zip

30093-

Home

(770) 935-6938

Family Status

Single adult

COB

Venezuela

Gender

Female

Housing

Doubling Up

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