Pancho - TOV-MAR-59

Code: TOV-MAR-59
Mercy ID: V-02070-01
Encounter Date: 10/20/2005
Last: Tovar
First: Maria estela
DOB: 08/31/1959
County: Fulton
Street: 1616 Peidmont Rd.
City: Atlanta
State: GA

Zip

30324-

Cell

(404) 438-6590

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: G. Landeros
Data Entry: R. Gonzalez