Pancho - ORT-NAL-84

Code: ORT-NAL-84
Mercy ID: V-00002-11
Encounter Date: 01/17/2000
Last: Ortiz
First: Nallely
DOB: 06/01/1984
County: Dekalb
Street: 5320 Roswell Rd. Apt K-2
City: Atlanta
State: GA

Zip

30342-

Home

(404) 255-9698

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Patricia Arrieta	06/30/1964	Mexico
Father	Ruben Ortiz	08/21/1960	Mexico
Step Parent	Jorge Ramirez	05/20/1964	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Riverwood High School
Grade: 10th.
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. Manzo
Data Entry: K. Aleman