Pancho - PON-DAN-00

Code: PON-DAN-00
Mercy ID: V-00662-11
Encounter Date: 10/17/2001
Last: Ponce
First: Daniela
DOB: 10/18/2000
County: Dekalb
Street: 1750 Briarwood Rd. AA-8 or CC-13
City: Atlanta
State: GA

Zip

30329-

Home

(404) 316-4670

Family Status

Attached youth

COB

Colombia

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Martha Ponce	04/05/1961	Colombia
Father	Javier Ponce	04/24/1974	Ecuador
Step Parent	N/A	N/A	N/A

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