Pancho - PER-SAN-82

Code: PER-SAN-82
Mercy ID: V-01889-01
Encounter Date: 04/26/2005
Last: Perez garay
First: Sandra
DOB: 08/27/1982
County: Dekalb
Street: 2925 North Dekalb Dr. Apt 107
City: Doraville
State: GA

Zip

30340-

Home

(770) 896-3159

Cell

(770) 875-6741

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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: YES
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. Perez
Data Entry: K. Aleman