Pancho - ARE-ROS-75

Code: ARE-ROS-75
Mercy ID: V-02568-01
Encounter Date: 03/03/2008
Last: Arevalo
First: Rosa
DOB: 09/25/1975
County: Gwinnett
Street: 3111 Winn Drive
City: Lawrenceville
State: GA

Zip

30044-

Cell

(770) 895-1041

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

some high school

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