Pancho - ART-VIR-87

Code: ART-VIR-87
Mercy ID: V-03205-01
Encounter Date: 11/05/2009
Last: Arteaga
First: Virginia
DOB: 08/15/1987
County: Gwinnett
Street: 4222 Beawerton Cr.
City: Loganville
State: GA

Zip

30052-

Cell

(770) 910-6730

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

High school graduate

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