Pancho - RAM-ANG-02

Code: RAM-ANG-02
Mercy ID: V-03477-14
Encounter Date: 12/01/2010
Last: Ramirez
First: Angelica
DOB: 04/05/2002
County: Gwinnett
Street: 1149 Guernsey Dr.
City: Lawrenceville
State: GA

Zip

30043-

Home

(770) 339-1735

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Francisca Ramirez	07/15/1971	Mexico
Father	Moises Ramirez	01/28/2010	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Mackendry Elem.
Grade: 3rd.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo