Pancho - POL-VIC-73

Code: POL-VIC-73
Mercy ID: V-01882-01
Encounter Date: 04/11/2005
Last: Bello
First: Victoria
DOB: 08/21/1973
County: Dekalb
Street: 2287 Plaster Rd. #7
City: Atlanta
State: GA

Zip

30345-

Home

(404) 399-7238

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Preschool

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