Pancho - BER-CHI-94

Code: BER-CHI-94
Mercy ID: V-00053-13
Encounter Date: 01/03/2000
Last: Bertalioni
First: Chiara
DOB: 12/11/1994
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 quiros	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: buleigh
Grade: Kinder
Who Can't Pickup the Child: rafael 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