Pancho - ACE-RAQ-78

Code: ACE-RAQ-78
Mercy ID: B-00001-01
Encounter Date: 07/09/1999
Last: Acevedos
First: Raquel
DOB: 07/02/1978
County: Not given
Street: 236 Buckhorn Dr.
City: Winder
State: GA

Zip

30680-

Home

(770) 586-0188

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Other

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: K. Aleman