Pancho - ORT-NAN-81

Code: ORT-NAN-81
Mercy ID: V-00346-01
Encounter Date: 11/28/2000
Last: Ortiz
First: Nancy
DOB: 06/20/1981
County: Fulton
Street: 2614 Old Hapeville Rd Apt-6
City: Atlanta
State: GA

Zip

30315-

Home

(404) 762-9900

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

some high 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