Pancho - FEL-ROS-68

Code: FEL-ROS-68
Mercy ID: V-02257-01
Encounter Date: 05/25/2006
Last: Felix
First: Rosa
DOB: 08/09/1968
County: Other
Street: not given
City: Not given
State: GA

Zip

00000-

Home

(978) 857-2011

Family Status

Unknow/Unreported

COB

Dominican Rep

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: G. Landeros
Data Entry: R. Gonzalez