Pancho - TOV-CLA-78

Code: TOV-CLA-78
Mercy ID: V-01997-01
Encounter Date: 07/29/2005
Last: Tovar
First: Claudia
DOB: 01/29/1978
County: Gwinnett
Street: 3728 Burnt Leaf Lane
City: Snellville
State: GA

Zip

30039-

Cell

(770) 905-1810

Family Status

Two parent family w/children

COB

Colombia

Gender

Female

Housing

Single Family

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: 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: G. Landeros
Data Entry: K. Aleman