Pancho - ORT-ALE-90

Code: ORT-ALE-90
Mercy ID: V-01324-12
Encounter Date: 09/17/2003
Last: Ortiz
First: Alejandra
DOB: 07/12/1990
County: Dekalb
Street: 707 Regency Woods Dr. 816
City: Atlanta
State: GA

Zip

30319-

Home

(678) 851-1416

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria G. Dominguez	N/A	Mexico
Father	Alejandro Ortiz	05/03/1955	Mexico
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