Pancho - ROD-GUA-67

Code: ROD-GUA-67
Mercy ID: V-00372-01
Encounter Date: 12/21/2000
Last: Rodriguez
First: Guadalupe
DOB: 01/28/1967
County: Cobb
Street: 4850 chastone stone ct
City: Power spring
State: GA

Zip

30127-

Home

(770) 425-6505

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: D. Gomez