Pancho - CRU-ALI-74

Code: CRU-ALI-74
Mercy ID: V-02701-01
Encounter Date: 01/23/2008
Last: Cruz
First: Alicia
DOB: 12/28/1974
County: Gwinnett
Street: 1374 Country Downs Drive
City: Norcross
State: GA

Zip

30093-

Cell

(678) 789-2906

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade school

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