Pancho - PER-HAY-80

Code: PER-HAY-80
Mercy ID: V-02338-01
Encounter Date: 10/09/2006
Last: Peralta
First: Hayra
DOB: 08/15/1980
County: Fulton
Street: 1951 S. Hampton Rd.
City: College park
State: GA

Zip

30349-

Cell

(404) 399-8999

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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. Perez
Data Entry: J. Manzo