Pancho - RAM-ORQ-79

Code: RAM-ORQ-79
Mercy ID: V-01998-01
Encounter Date: 07/27/2005
Last: Ramirez
First: Orquidea
DOB: 01/17/1979
County: Fulton
Street: 1505 CMA #97
City: Atlanta
State: GA

Zip

30318-

Home

(404) 352-5098

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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: G. Landeros
Data Entry: K. Aleman