Pancho - CON-MID-98

Code: CON-MID-98
Mercy ID: V-00610-12
Encounter Date: 05/23/1998
Last: Contreras
First: Midelvia
DOB: 05/23/1998
County: Dekalb
Street: P.O. Box 1327
City: Decatur
State: GA

Zip

30031-

Home

(404) 298-7258

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Shelter

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Miriam Hernandez	10/08/1972	El Salvador
Father	Jose A. Contreras	N/A	El Salvador
Step Parent	Dioselin Rebollar	N/A	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: K. Aleman
Data Entry: K. Aleman