Pancho - DIA-MAR-60

Code: DIA-MAR-60
Mercy ID: V-02248-01
Encounter Date: 05/18/2006
Last: Diaz
First: Maria janet
DOB: 06/10/1960
County: Fulton
Street: not given
City: Not given
State: GA

Zip

00000-

Home

(404) 713-1227

Family Status

Single adult

COB

Guatemala

Gender

Female

Housing

Street

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