Pancho - ARE-DAL-78

Code: ARE-DAL-78
Mercy ID: V-02273-01
Encounter Date: 06/14/2006
Last: Arellano
First: Dalia
DOB: 04/30/1978
County: Gwinnett
Street: 616 Willow Dr
City: Norcross
State: GA

Zip

30093-

Cell

(678) 522-8136

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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