Pancho - PIN-YES-77

Code: PIN-YES-77
Mercy ID: V-02134-01
Encounter Date: 11/30/2005
Last: Pineda
First: Yesica
DOB: 02/21/1977
County: Dekalb
Street: 1451 Briarwood Rd #33
City: Atlanta
State: GA

Zip

30319-

Home

(770) 478-9633

Cell

(404) 418-2447

Family Status

Two parent family w/children

COB

Honduras

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