Pancho - CAM-TON-75

Code: CAM-TON-75
Mercy ID: V-00341-01
Encounter Date: 11/14/2000
Last: Camargo
First: Tonya
DOB: 01/12/1975
County: Gwinnett
Street: 158 Martin Circle
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 935-4471

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Not Homeless

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: J. Manzo
Data Entry: K. Aleman