Pancho - TOR-MAT-74

Code: TOR-MAT-74
Mercy ID: V-03191-01
Encounter Date: 10/21/2009
Last: Torrez
First: Martha
DOB: 01/17/1974
County: Clayton
Street: 444 Cedar Court
City: Riverdale
State: GA

Zip

30274-

Home

(770) 603-2717

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

College Degree

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: C. Martinez
Data Entry: J. Manzo