Pancho - TOR-CLA-63

Code: TOR-CLA-63
Mercy ID: V-03107-01
Encounter Date: 06/29/2009
Last: Torres
First: Clara
DOB: 06/18/1963
County: Fortpayne alabama
Street: 0309 Thousand Rd.
City: Valleyhead
State: AL

Zip

35989-

Cell

(256) 630-4773

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Grade 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