Pancho - BEL-ARE-66

Code: BEL-ARE-66
Mercy ID: V-03524-01
Encounter Date: 02/02/2011
Last: Bello
First: Arelis
DOB: 07/11/1966
County: Gwinnett
Street: 355 Sweetwater Rd. Apt. 8108
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 717-9231

Family Status

Adult couple-no children

COB

Dominican Rep

Gender

Female

Housing

Doubling Up

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