Pancho - CAR-JUA-80

Code: CAR-JUA-80
Mercy ID: V-02784-01
Encounter Date: 05/16/2008
Last: Carmona
First: Juanita
DOB: 10/11/1980
County: Gwinnett
Street: 6187 Tracy Bally Dr.
City: Norcross
State: GA

Zip

30093-

Home

(770) 248-1290

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Single Family

Education Level

some high 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: 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: G. Landeros
Data Entry: J. Manzo