Pancho - CAM-MAN-70

Code: CAM-MAN-70
Mercy ID: V-02771-01
Encounter Date: 04/28/2008
Last: Campos
First: Manuela
DOB: 10/14/1970
County: Dekalb
Street: 5825 Buford Hwy A-18
City: Chamblee
State: GA

Zip

30341-

Cell

(404) 235-1825

Family Status

Adult couple-no children

COB

El Salvador

Gender

Female

Housing

Doubling Up

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