Pancho - PER-BAN-99

Code: PER-BAN-99
Mercy ID: V-01183-11
Encounter Date: 06/24/2003
Last: Perez
First: Banessa
DOB: 11/18/1999
County: Fulton
Street: 501 Connell Ave. D7
City: Atlanta
State: GA

Zip

30315-

Home

(404) 762-9021

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Yanet Hernandez	11/25/1980	Cuba
Father	Felix Perez	N/A	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: K. Aleman
Data Entry: K. Aleman