Pancho - RAM-ANA-70

Code: RAM-ANA-70
Mercy ID: V-02649-01
Encounter Date: 11/16/2007
Last: Ramirez
First: Ana
DOB: 02/12/1970
County: Cobb
Street: 4925 Shallow Road
City: Kennesaw
State: GA

Zip

30144-

Cell

(404) 429-4698

Family Status

Two parent family w/children

COB

Perú

Gender

Female

Housing

Single Family

Education Level

Some College

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: 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: G. Landeros
Data Entry: J. Manzo