Pancho - ALV-ESP-56

Code: ALV-ESP-56
Mercy ID: B-00022-01
Encounter Date: 11/06/1996
Last: Alvares
First: Esperanza
DOB: 08/01/1956
County: Other
Street: 2644 Balmar Dr.
City: Doraville
State: GA

Zip

30340-

Home

(000) 000-0000

Family Status

Unattached youth

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

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