Pancho - VIL-IRM-59

Code: VIL-IRM-59
Mercy ID: V-00380-01
Encounter Date: 01/05/2001
Last: Villa
First: Irma
DOB: 07/18/1959
County: Clayton
Street: 830 Laurel St.
City: Forest park
State: GA

Zip

30297-

Home

(770) 441-2741

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Vocational/Technical

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: YES
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