Pancho - OZA-JEL-78

Code: OZA-JEL-78
Mercy ID: V-01827-01
Encounter Date: 02/10/2005
Last: Oza
First: Jelitza
DOB: 09/04/1978
County: Hall
Street: 1014 Lenox Park
City: Gainsville
State: GA

Zip

30507-

Home

(678) 656-3796

Family Status

Adult coupie-no children

COB

Venezuela

Gender

Female

Housing

Not Homeless

Education Level

Vocational/Technical

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: No
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