Pancho - BON-ROS-98

Code: BON-ROS-98
Mercy ID: B-00046-01
Encounter Date: 06/30/1998
Last: Bonilla
First: Rosa
DOB: 07/21/1973
County: Gwinnett
Street: 1212 Ivey Park Lane
City: Norcross
State: GA

Zip

30092-

Home

(770) 448-0379

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Other

Education Level

Other

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: K. Aleman