Pancho - CRU-ZLI-81

Code: CRU-ZLI-81
Mercy ID: V-02951-01
Encounter Date: 11/25/2008
Last: Cruz
First: Liliana
DOB: 12/15/1982
County: Forsyth
Street: 2020 Pilgrim Road # 103
City: Cumming
State: GA

Zip

30040-

Cell

(678) 851-2427

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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