Pancho - OST-JES-74

Code: OST-JES-74
Mercy ID: V-00378-01
Encounter Date: 01/02/2001
Last: Ostuni
First: Jessica
DOB: 06/20/1974
County: Cherokee
Street: 422 savannah Rd
City: Woodstock
State: GA

Zip

30188-

Home

(770) 517-5916

Family Status

Two parent family w/children

COB

USA

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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