Pancho - ORE-ANG-66

Code: ORE-ANG-66
Mercy ID: V-01191-01
Encounter Date: 04/15/2003
Last: Orejuela
First: Angela
DOB: 02/28/1966
County: Gwinnett
Street: 3355 Sweatwater Rd. Apt 9101
City: Lawrenceville
State: GA

Zip

30044-

Home

(999) 999-9999

Family Status

Adult coupie-no children

COB

Colombia

Gender

Female

Housing

Not Homeless

Education Level

College Degree

Home Owner

YES

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