Pancho - TAP-ANA-74

Code: TAP-ANA-74
Mercy ID: V-02255-01
Encounter Date: 05/30/2006
Last: Tapia
First: Ana
DOB: 05/26/1974
County: Cobb
Street: 1788 Austell Rd
City: Marietta
State: GA

Zip

30008-

Cell

(678) 887-0255

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: 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