Pancho - DEL-FAN-59

Code: DEL-FAN-59
Mercy ID: V-00344-01
Encounter Date: 11/08/2000
Last: Delgado
First: Fanny
DOB: 10/18/1959
County: Cobb
Street: 2721 Norman Dr. North Apt. 19
City: Smyrna
State: GA

Zip

30080-

Home

(770) 612-9719

Family Status

Single parent w/children

COB

Venezuela

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: J. Manzo
Data Entry: Y. Garcia