Pancho - ORE-REY-61

Code: ORE-REY-61
Mercy ID: V-00269-01
Encounter Date: 08/23/2000
Last: Orellana
First: Reyna
DOB: 12/08/1961
County: Cobb
Street: 5950 Garner Rd
City: Mableton
State: GA

Zip

30126-

Home

(678) 945-9515

Family Status

Single parent w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

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: D. Gomez