Pancho - URI-MER-63

Code: URI-MER-63
Mercy ID: V-02136-01
Encounter Date: 01/11/2006
Last: Uribe
First: Mercedes
DOB: 07/23/1963
County: Gwinnett
Street: 672 Riverlandin Dr
City: Lawrenceville
State: GA

Zip

30045-

Home

(678) 887-4181

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Vocational/Technical

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: J. Perez
Data Entry: R. Gonzalez