Pancho - RIN-AME-70

Code: RIN-AME-70
Mercy ID: V-02619-01
Encounter Date: 10/11/2007
Last: Rincon
First: Amelia
DOB: 06/18/1970
County: Henry
Street: 264 Valley Hill Road
City: Stockbridge
State: GA

Zip

30281-

Cell

(770) 912-6079

Family Status

Two parent family w/children

COB

Colombia

Gender

Female

Housing

Single Family

Education Level

College Degree

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: J. Perez
Data Entry: J. Manzo