Pancho - RAM-REY-69

Code: RAM-REY-69
Mercy ID: V-00417-01
Encounter Date: 02/21/2001
Last: Ramirez
First: Reyna
DOB: 01/06/1969
County: Gwinnett
Street: 1178 karia joe dr
City: Lilburn
State: GA

Zip

30047-

Home

(770) 638-4082

Family Status

Single parent w/children

COB

Mexico

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: YES
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