Pancho - PER-SHE-52

Code: PER-SHE-52
Mercy ID: V-02556-01
Encounter Date: 08/02/2007
Last: Perez
First: Sheila
DOB: 05/13/1952
County: Dekalb
Street: 5881 Pine Road
City: Doraville
State: GA

Zip

30340-

Home

(770) 248-4069

Cell

(770) 285-4310

Family Status

Adult couple-no children

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: 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