Pancho - VAC-YES-82

Code: VAC-YES-82
Mercy ID: V-02091-01
Encounter Date: 10/18/2005
Last: Vaca
First: Yesenia
DOB: 09/15/1982
County: Fulton
Street: 3804 Martin Luther King Dr.
City: Atlanta
State: GA

Zip

30331-

Home

(404) 691-0528

Family Status

Single adult

COB

Honduras

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: G. Landeros
Data Entry: R. Gonzalez