Pancho - MAR-MIC-99

Code: MAR-MIC-99
Mercy ID: V-01175-11
Encounter Date: 05/07/2003
Last: Martinez
First: Michelle
DOB: 02/02/1999
County: Fulton
Street: 5801 Kingport Dr.
City: Atlanta
State: GA

Zip

30342-

Home

(404) 759-0152

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Patricia Clemente	01/01/1976	Mexico
Father	Cesar Martinez Aguilar	05/09/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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