Pancho - OVA-LET-76

Code: OVA-LET-76
Mercy ID: V-03190-01
Encounter Date: 10/07/2009
Last: Ovando
First: Leticia
DOB: 09/15/1976
County: Gwinnett
Street: 402 Willow Trail
City: Norcross
State: GA

Zip

30093-

Cell

(404) 421-2836

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Single Family

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: J. Perez
Data Entry: J. Manzo