Pancho - VAR-MAR-69

Code: VAR-MAR-69
Mercy ID: V-02716-01
Encounter Date: 02/08/2008
Last: Vargas
First: Maria
DOB: 10/23/1969
County: Fulton
Street: 2715 Chattachao Road
City: Roswell
State: GA

Zip

30075-

Cell

(404) 246-4824

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Some College

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