Pancho - CLA-JUL-75

Code: CLA-JUL-75
Mercy ID: V-02491-01
Encounter Date: 05/14/2007
Last: Claro
First: Julia
DOB: 01/21/1975
County: Dekalb
Street: 4920 Winterchaper Rd. N-14
City: Doraville
State: GA

Zip

30360-

Home

(404) 396-8648

Family Status

Two parent family w/children

COB

Honduras

Gender

Female

Housing

Not Homeless

Education Level

Preschool

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: J. Manzo