Pancho - ROM-DEL-74

Code: ROM-DEL-74
Mercy ID: V-02407-01
Encounter Date: 02/08/2007
Last: Romero
First: Delfina
DOB: 12/14/1974
County: Cobb
Street: 1096 Atlanta Road Lot D-34
City: Marietta
State: GA

Zip

30060-

Cell

(404) 396-8967

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: J. Perez
Data Entry: J. Manzo