Pancho - BON-REY-63

Code: BON-REY-63
Mercy ID: V-00143-01
Encounter Date: 03/21/2000
Last: Bonilla
First: Reyna
DOB: 01/06/1963
County: Clayton
Street: 1466 Rockcut rd apt B-2
City: Forest park
State: GA

Zip

30297-

Home

(404) 361-0765

Family Status

Adult coupie-no children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

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: J. Perez
Data Entry: D. Gomez