Pancho - RAM-MIR-02

Code: RAM-MIR-02
Mercy ID: V-02187-11
Encounter Date: 03/29/2006
Last: Ramirez sandoval
First: Miriam
DOB: 04/26/2002
County: Dekalb
Street: 2235 Plaster Rd Apt #60
City: Atlanta
State: GA

Zip

30345-

Cell

(404) 396-2960

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Erika Sandoval Cervantes	04/23/1982	Mexico
Father	Ismael Ramirez	01/14/1981	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: R. Gonzalez
Data Entry: R. Gonzalez