Pancho - VIL-IRM-74

Code: VIL-IRM-74
Mercy ID: V-02506-01
Encounter Date: 05/30/2007
Last: Villatoro
First: Irma
DOB: 05/13/1974
County: Cobb
Street: 671 Aire Rd.
City: Mableton
State: GA

Zip

30126-

Home

(770) 940-2837

Cell

(770) 941-2837

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Not Homeless

Education Level

Adult, no formal education

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: G. Landeros
Data Entry: J. Manzo