Pancho - PER-ELI-74

Code: PER-ELI-74
Mercy ID: V-03179-01
Encounter Date: 09/28/2009
Last: Perez
First: Elizabeth
DOB: 05/07/1974
County: Hall
Street: 999 Shelter
City: Gainsville
State: GA

Zip

30501-

Cell

(770) 536-5860

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Shelter

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: 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