Pancho - HER-MAR-94

Code: HER-MAR-94
Mercy ID: V-01072-11
Encounter Date: 05/21/2003
Last: Hernandez
First: Mariela
DOB: 02/02/1994
County: Dekalb
Street: 1369 N. Cliff Valley Way G4
City: Atlanta
State: GA

Zip

30319-

Home

(404) 417-9303

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Clara Romero Rayo	09/18/1976	Mexico
Father	Tiburcio Hernandez	08/11/1970	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: N/A
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