Pancho - MAC-MIC-04

Code: MAC-MIC-04
Mercy ID: V-01067-12
Encounter Date: 08/08/2007
Last: Macedo
First: Michelle
DOB: 06/12/2004
County: Cobb
Street: 131 Appleton Cir
City: Marietta
State: GA

Zip

30008-

Cell

(404) 380-4145

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Marvella Macedo	01/11/1980	Mexico
Father	Miguel Mendoza	09/24/1976	Mexico
Step Parent	Jose Soto	11/06/1972	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Fair oaks
Grade: Kinder
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Y. Garcia
Data Entry: J. Manzo