Pancho - BER-IND-92

Code: BER-IND-92
Mercy ID: V-00053-12
Encounter Date: 01/03/2000
Last: Berttalioni
First: Indira
DOB: 12/20/1992
County: Not given
Street: 105 etheretge rd
City: Temple
State: GA

Zip

30179-

Home

(770) 562-9297

Family Status

Attached youth

COB

Costa Rica

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	maria quiros	04/30/1965	Costa Rica
Father	rafael bertalioni	10/26/1951	Costa Rica
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: duleigh elem
Grade: 1st.
Who Can't Pickup the Child: rafael bertalioni dad
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Manzo
Data Entry: D. Gomez