Pancho - CAM-MAR-75

Code: CAM-MAR-75
Mercy ID: V-02111-01
Encounter Date: 11/16/2005
Last: Camacho
First: Margarita
DOB: 02/22/1975
County: Gwinnett
Street: 4300 Jimmy Carte Blvd. Apt. 720
City: Norcross
State: GA

Zip

30093-

Cell

(404) 376-9725

Family Status

Two parent family w/children

COB

Mexico

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: 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