Pancho - ORE-EME-01

Code: ORE-EME-01
Mercy ID: V-01081-11
Encounter Date: 01/08/2002
Last: Orellana
First: Emily
DOB: 05/08/2001
County: Gwinnett
Street: 6807 Graves Mill Dr.
City: Norcross
State: GA

Zip

30093-

Home

(770) 938-0268

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Nereyda Ramirez	08/11/1975	Mexico
Father	Francisco Orellana	05/25/1969	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: Y. Garcia
Data Entry: K. Aleman