Pancho - ORT-VER-11

Code: ORT-VER-11
Mercy ID: V-00016-11
Encounter Date: 01/05/2000
Last: Ortiz
First: Veronica
DOB: 02/03/1994
County: Cherokee
Street: 237 park ave.
City: Woodstack
State: GA

Zip

30188-

Home

(770) 924-4110

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	manuela estrada	04/23/1970	Mexico
Father	tomas ortiz	09/22/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: N/A
Grade: 1st.
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: S. Aviña