Pancho - VAR-ADE-74

Code: VAR-ADE-74
Mercy ID: V-02846-01
Encounter Date: 07/01/2008
Last: Vargas
First: Adelina
DOB: 02/17/1974
County: Dekalb
Street: 6750 Peachtree Ind. Blv. # 502
City: Atlanta
State: GA

Zip

30360-

Cell

(404) 484-7409

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Preschool

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