Pancho - CIR-MAR-69

Code: CIR-MAR-69
Mercy ID: V-00232-01
Encounter Date: 06/06/2000
Last: Ciriaco
First: Maria
DOB: 02/04/1969
County: Gwinnett
Street: 2702 arbor dr
City: Duluth
State: GA

Zip

30096-

Home

(770) 806-5881

Family Status

Two parent family 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: YES
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. Manzo
Data Entry: S. Aviña