Pancho - FRE-SIL-65

Code: FRE-SIL-65
Mercy ID: V-01860-01
Encounter Date: 03/21/2005
Last: Fresa
First: Silvana
DOB: 07/24/1965
County: Fulton
Street: 1504 Jador Pov QWH
City: Sandy springs
State: GA

Zip

30350-

Home

(678) 508-4381

Family Status

Two parent family 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: G. Landeros
Data Entry: K. Aleman