Pancho - CHA-CAS-97

Code: CHA-CAS-97
Mercy ID: V-00702-11
Encounter Date: 10/03/2001
Last: Chavez
First: Casandra
DOB: 07/30/1997
County: Fulton
Street: 2960 Sandy Circe
City: Riverdale
State: GA

Zip

30296-

Home

(770) 909-8193

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Josefina Chavez	02/20/1965	Mexico
Father	Richard Claudio Chavez	06/08/1966	EEUU
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: Pre-K
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: Y. Garcia
Data Entry: K. Aleman