Pancho - BER-ELI-56

Code: BER-ELI-56
Mercy ID: V-03012-01
Encounter Date: 02/23/2009
Last: Bernal
First: Elizabeth
DOB: 06/11/1956
County: Fulton
Street: 3021 Greenhouse Parkway
City: Alpharetta
State: GA

Zip

30022-

Cell

(678) 913-3082

Family Status

Adult couple-no children

COB

Colombia

Gender

Female

Housing

Single Family

Education Level

College Degree

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: J. Manzo