Pancho - AVA-MAU-80

Code: AVA-MAU-80
Mercy ID: V-03047-01
Encounter Date: 04/01/2009
Last: Avalos
First: Mauricia
DOB: 09/22/1980
County: Gwinnett
Street: 999 no la uiso dar
City: Duluth
State: GA

Zip

30096-

Cell

(404) 492-2009

Family Status

Two parent family w/children

COB

Mexico

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: YES
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