Pancho - BAR-EVE-78

Code: BAR-EVE-78
Mercy ID: V-03076-01
Encounter Date: 05/18/2009
Last: Barrios
First: Evelyn
DOB: 04/08/1978
County: Cobb
Street: 400 Alexander Dr. Apt. 201
City: Canton
State: GA

Zip

30114-

Cell

(678) 315-9373

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

Some College

Home Owner

YES

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