Pancho - CAM-WEN-87

Code: CAM-WEN-87
Mercy ID: V-03139-01
Encounter Date: 08/17/2009
Last: Campos
First: Wendy
DOB: 11/14/1987
County: Dekalb
Street: 3536 Buford Hwy # 8
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 246-4333

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

H.S. equivalency diploma

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: G. Landeros
Data Entry: J. Manzo