Pancho - ZAR-MAR-74

Code: ZAR-MAR-74
Mercy ID: V-02090-01
Encounter Date: 11/03/2005
Last: Zaragoza
First: Martha
DOB: 11/27/1974
County: Cobb
Street: 1034 Franklin Rd. #3
City: Marietta
State: GA

Zip

30064-

Home

(770) 912-2617

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Not Homeless

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: 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