Pancho - ORT-CES-96

Code: ORT-CES-96
Mercy ID: V-03297-21
Encounter Date: 04/14/2010
Last: Ortiz
First: Cesar
DOB: 02/03/1996
County: Gwinnett
Street: 696 Killian Hill Road
City: Lilburn
State: GA

Zip

30047-

Cell

(404) 399-5581

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Morales	06/02/1976	Mexico
Father	Nicolas Ortiz	05/09/1974	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Trickum Middle School
Grade: 8th.
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