Pancho - RIV-REY-80

Code: RIV-REY-80
Mercy ID: V-03113-01
Encounter Date: 07/01/2009
Last: Rivera
First: Reyna
DOB: 05/22/1980
County: Henry
Street: 610 Summerset Dr.
City: Stockbridga
State: GA

Zip

30281-

Cell

(678) 497-5724

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Single Family

Education Level

Some College

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: YES
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