Pancho - ALO-MAY-65

Code: ALO-MAY-65
Mercy ID: V-01793-01
Encounter Date: 12/23/2004
Last: Alonso
First: Mayra
DOB: 06/07/1965
County: Cobb
Street: Not given
City: Podwer spring
State: GA

Zip

00000-0

Cell

(678) 754-7944

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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