Pancho - ACO-CON-56

Code: ACO-CON-56
Mercy ID: V-02082-01
Encounter Date: 10/26/2005
Last: Acosta
First: Consuelo
DOB: 04/29/1956
County: Dekalb
Street: 3957 Ingle Oak Drive
City: Doraville
State: GA

Zip

30340-

Cell

(678) 334-4450

Family Status

Single adult

COB

Honduras

Gender

Female

Housing

Doubling Up

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: R. Gonzalez