Pancho - CRU-XIO-99

Code: CRU-XIO-99
Mercy ID: V-00672-11
Encounter Date: 09/05/2001
Last: Cruz
First: Xiomara
DOB: 12/03/1999
County: Dekalb
Street: 4095 English Oak Dr.
City: Doraville
State: GA

Zip

30340-

Home

(770) 630-3275

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Reyna Cruz	09/07/1969	Mexico
Father	N/A	N/A	Mexico
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