Pancho - MON-AZU-94

Code: MON-AZU-94
Mercy ID: V-00977-12
Encounter Date: 07/17/2002
Last: Montufar
First: Azucena
DOB: 07/07/1994
County: Fulton
Street: 4689 Roswell Rd. Apt. F3
City: Atlanta
State: GA

Zip

30342-

Home

(404) 843-0557

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Margarita Maldonado	06/10/1972	Mexico
Father	Ismael Montufar	11/22/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Highpoint Elementary
Grade: 3rd.
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