Pancho - RDZ-ROS-78

Code: RDZ-ROS-78
Mercy ID: V-03438-01
Encounter Date: 10/08/2010
Last: Rodriguez
First: Rosalba
DOB: 08/09/1978
County: Clayton
Street: 6347 Tara Blvd. Lot 48
City: Jonesboro
State: GA

Zip

30236-

Cell

(678) 651-6054

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Single Family

Education Level

some high 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: 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: J. Perez
Data Entry: J. Manzo