Pancho - VAL-JEN-02

Code: VAL-JEN-02
Mercy ID: V-01103-11
Encounter Date: 04/02/2003
Last: Vallejo
First: Jennifer
DOB: 02/21/2002
County: Dekalb
Street: 3652 Pierce Dr. Apt. A-6
City: Chamblee
State: GA

Zip

30341-

Home

(404) 449-9013

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Hilda Ramos	10/27/1975	Mexico
Father	Eric Vallejo	10/24/1980	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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