Pancho - SAL-MAR-73

Code: SAL-MAR-73
Mercy ID: V-02062-01
Encounter Date: 10/21/2005
Last: Salazar
First: Maria jose
DOB: 04/26/1973
County: Dekalb
Street: 6800 Peachtree Industrial Blvd.
City: Doraville
State: GA

Zip

30360-

Cell

(770) 256-6845

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Not Homeless

Education Level

Grade school

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. Perez
Data Entry: R. Gonzalez