Pancho - FAL-MAR-81

Code: FAL-MAR-81
Mercy ID: V-02790-01
Encounter Date: 05/19/2008
Last: Falcon
First: Maritza
DOB: 12/30/1981
County: Gwinnett
Street: 3171 Terrace Court
City: Norcross
State: GA

Zip

30092-

Cell

(678) 755-8723

Family Status

Two parent family w/children

COB

Uruguay

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: J. Perez
Data Entry: C. Martinez