Pancho - RAM-ANA-83

Code: RAM-ANA-83
Mercy ID: V-01383-01
Encounter Date: 10/20/2003
Last: Ramirez
First: Ana iris
DOB: 05/22/1983
County: Dekalb
Street: 2095 Burton Pl. E-3
City: Atlanta
State: GA

Zip

30319-

Home

(404) 315-9120

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

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: YES
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. Manzo
Data Entry: K. Aleman