Pancho - BRA-MAR-84

Code: BRA-MAR-84
Mercy ID: V-03497-01
Encounter Date: 01/05/2011
Last: Bravo
First: Maria
DOB: 11/19/1984
County: Fulton
Street: 141 Old Holcombridge Way
City: Roswell
State: GA

Zip

30076-

Cell

(678) 891-8474

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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: C. Martinez
Data Entry: J. Manzo