Pancho - ORT-NAN-78

Code: ORT-NAN-78
Mercy ID: V-00821-01
Encounter Date: 01/28/2002
Last: Gonzalez ortiz
First: Nancy
DOB: 08/08/1978
County: Cherokee
Street: 6465 Hwy 9 Lote F24
City: Alpharetta
State: GA

Zip

30004-

Home

(678) 393-1639

Family Status

Two parent family w/children

COB

Mexico

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