Pancho - ROG-JOA-03

Code: ROG-JOA-03
Mercy ID: V-03036-12
Encounter Date: 04/01/2009
Last: Rogel
First: Joana
DOB: 01/21/2003
County: Fulton
Street: 501 Conel Ave. L-C2
City: Atlanta
State: GA

Zip

30315-

Cell

(404) 748-5318

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Jobana Ocampo	06/14/1976	Mexico
Father	Antonio Rogel	06/08/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Emma Hutchinson
Grade: 1st.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo