Pancho - MEN-NAT-01

Code: MEN-NAT-01
Mercy ID: V-00957-11
Encounter Date: 09/18/2002
Last: Mendez
First: Natalia
DOB: 01/14/2001
County: Gwinnett
Street: 3042 Clari dr.
City: Duluth
State: GA

Zip

30096-

Home

(404) 982-1086

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Father
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: Y. Garcia
Data Entry: K. Aleman