Pancho - ROM-ANG-91

Code: ROM-ANG-91
Mercy ID: V-02861-01
Encounter Date: 07/29/2008
Last: Romero
First: Angelina
DOB: 03/28/1991
County: Dekalb
Street: 1611 Briarwood Road Apt. C
City: Atlanta
State: GA

Zip

30319-

Cell

(404) 447-8425

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high school

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. Perez
Data Entry: J. Manzo