Pancho - ROD-ROS-80

Code: ROD-ROS-80
Mercy ID: V-01842-01
Encounter Date: 02/22/2005
Last: Rodriguez
First: Rosana
DOB: 12/16/1980
County: Cobb
Street: 2400 Emory Ln.
City: Marietta
State: GA

Zip

30068-

Cell

(404) 933-0698

Family Status

Single parent 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: 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: G. Landeros
Data Entry: K. Aleman