Pancho - ORT-IRI-78

Code: ORT-IRI-78
Mercy ID: V-00685-01
Encounter Date: 09/19/2001
Last: Ortiz
First: Iris
DOB: 11/07/1978
County: Gwinnett
Street: 3386 Rolling Brook Way
City: Duluth
State: GA

Zip

30096-

Home

(678) 473-9219

Family Status

Two parent family w/children

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

some high 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: 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. Perez
Data Entry: K. Aleman