Pancho - VEG-EST-01

Code: VEG-EST-01
Mercy ID: V-01202-13
Encounter Date: 04/30/2003
Last: Vega
First: Estefany
DOB: 05/07/2001
County: Dekalb
Street: 3556 Meadowglen Village Lane #E
City: Doraville
State: GA

Zip

30340-

Home

(770) 939-3042

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Guadalupe Olvera	01/28/1973	Mexico
Father	Jose Raul Vega	11/05/1970	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