Pancho - HER-DIA-97

Code: HER-DIA-97
Mercy ID: V-00865-11
Encounter Date: 04/02/2003
Last: Herrera
First: Diana
DOB: 04/22/1997
County: Dekalb
Street: 3276 Oakwood Village #B
City: Chamblee
State: GA

Zip

30341-

Home

(404) 914-6469

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Ana Juarez	11/08/1975	Mexico
Father	Carmelo Herrera	07/16/1964	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Henderson Mill Elementary
Grade: Kinder
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