Pancho - ALD-ROS-56

Code: ALD-ROS-56
Mercy ID: B-00025-01
Encounter Date: 12/15/1993
Last: Aldana
First: Rosalinda
DOB: 12/04/1956
County: Cobb
Street: 425 Lake Dr. Apt H4
City: Marietta
State: GA

Zip

30060-

Home

(000) 919-8088

Family Status

Unknow/Unreported

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

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. Manzo
Data Entry: K. Aleman