Pancho - RIV-ERI-84

Code: RIV-ERI-84
Mercy ID: V-02128-01
Encounter Date: 12/13/2005
Last: Rivas
First: Erica
DOB: 07/24/1984
County: Gwinnett
Street: 4294 Hoekins
City: Ln.
State: GA

Zip

30096-

Home

(678) 913-7936

Family Status

Adult coupie-no children

COB

El Salvador

Gender

Female

Housing

Not Homeless

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: 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