Pancho - IRM-ORG-90

Code: IRM-ORG-90
Mercy ID: V-02275-11
Encounter Date: 11/18/2009
Last: Organista
First: Irma
DOB: 09/01/1990
County: Fulton
Street: 4616 Roswell Road Apt. A-4
City: Atlanta
State: GA

Zip

30342-

Home

(404) 943-0442

Family Status

Single adult

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Alicia Silverio	06/16/1972	Mexico
Father	Julian Organista	01/03/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Adulto/Soltero
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: C. Martinez
Data Entry: J. Manzo