Pancho - BUS-ANA-67

Code: BUS-ANA-67
Mercy ID: V-02415-01
Encounter Date: 02/21/1967
Last: Bustamante
First: Ana
DOB: 04/16/1967
County: Clayton
Street: 1693 Tara Boulevard Rd.
City: Jonesboro
State: GA

Zip

30238-

Cell

(404) 399-9253

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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: 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: G. Landeros
Data Entry: J. Manzo