Pancho - ORG-SAN-97

Code: ORG-SAN-97
Mercy ID: V-02275-12
Encounter Date: 11/18/2009
Last: Organista
First: Sandra
DOB: 09/29/1997
County: Fulton
Street: 4616 Roswell Road Apt. A-4
City: Atlanta
State: GA

Zip

30342-

Home

(404) 943-0442

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Single Family

Education Level

Grade 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: Parents
Name of School: Ridgevieww Charter
Grade: 6th.
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