Pancho - ADO-SHE-79

Code: ADO-SHE-79
Mercy ID: V-02073-01
Encounter Date: 10/14/2005
Last: Adorno
First: Sheila
DOB: 08/09/1979
County: Clayton
Street: 1160 Rock Spring
City: Forest park
State: GA

Zip

30297-

Cell

(404) 361-5814

Family Status

Two parent family w/children

COB

Puerto Rico

Gender

Female

Housing

Doubling Up

Education Level

some high 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: G. Landeros
Data Entry: R. Gonzalez