Pancho - SIE-LAU-70

Code: SIE-LAU-70
Mercy ID: V-02122-01
Encounter Date: 11/29/2005
Last: Sierra eugenio
First: Laura
DOB: 08/19/1970
County: Fulton
Street: 3210 Mathieson Dr
City: Atlanta
State: GA

Zip

30305-

Home

(404) 447-3143

Family Status

Two parent family w/children

COB

Mexico

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