Pancho - VEN-IRI-73

Code: VEN-IRI-73
Mercy ID: V-01932-01
Encounter Date: 06/15/2005
Last: Ventura
First: Iris
DOB: 09/29/1973
County: Gwinnett
Street: 6141 Rotondo Place
City: Norcross
State: GA

Zip

30093-

Home

(770) 934-1872

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

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: J. Manzo
Data Entry: K. Aleman