Pancho - AGU-PAT-64

Code: AGU-PAT-64
Mercy ID: B-00033-01
Encounter Date: 09/16/1997
Last: Aguilar
First: Patricia
DOB: 08/04/1964
County: Not given
Street: n/a
City: n/a
State: GA

Zip

00000-0000

Home

(770) 279-8330

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

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. Manzo
Data Entry: K. Aleman