Pancho - ALO-IRM-68

Code: ALO-IRM-68
Mercy ID: B-00023-01
Encounter Date: 10/01/1996
Last: Alonso
First: Irma
DOB: 05/13/1968
County: Other
Street: 532 Cleaveland Ave Apt 52B
City: Atlanta
State: GA

Zip

33015-

Home

(404) 266-8700

Family Status

Adult coupie-no children

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