Pancho - ESC-MAR-85

Code: ESC-MAR-85
Mercy ID: V-01950-01
Encounter Date: 05/13/2005
Last: Escobar
First: Maria
DOB: 08/15/1985
County: Dekalb
Street: Not given
City: Austell
State: GA

Zip

30168-

Home

(770) 256-4847

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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