Pancho - RAM-ELI-04

Code: RAM-ELI-04
Mercy ID: V-01643-13
Encounter Date: 07/28/2004
Last: Ramos
First: Elizabeth
DOB: 04/16/2004
County: Gwinnett
Street: 5615 Hammond Dr.
City: Norcross
State: GA

Zip

30071-

Home

(404) 416-6260

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Imelda Mata	06/29/1972	Mexico
Father	Juan Carlos Ramos	03/30/1982	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: Y. Garcia
Data Entry: K. Aleman