Pancho - RIV-PIL-95

Code: RIV-PIL-95
Mercy ID: V-01117-12
Encounter Date: 04/09/2003
Last: Rivera
First: Pilly
DOB: 05/03/1995
County: Cobb
Street: 750 Six Flags Rd. Lot 450
City: Austell
State: GA

Zip

30168-

Home

(770) 745-1864

Cell

(404) 587-2968

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Lorena Estrada	12/27/1968	Guatemala
Father	Julio Rivera	12/27/1969	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Liddley Middle
Grade: 6th.
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