Pancho - CRU-NOE-69

Code: CRU-NOE-69
Mercy ID: V-02693-01
Encounter Date: 01/17/2008
Last: Cruz
First: Noemi
DOB: 01/08/1969
County: Cobb
Street: 2405 Chauncey Lane
City: Marietta
State: GA

Zip

30064-

Home

(770) 726-7430

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

H.S. equivalency diploma

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: 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