Pancho - CHA-MAR-91

Code: CHA-MAR-91
Mercy ID: V-01203-11
Encounter Date: 04/30/2003
Last: Chacon
First: Martha constanza
DOB: 02/27/1991
County: Fulton
Street: 66 Northwood Dr.
City: Atlanta
State: GA

Zip

30342-

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Martha Chacon	11/28/1971	El Salvador
Father	Santo Ricardo Constanza	N/A	El Salvador
Step Parent	Angel Mendoza	09/15/1975	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: N/A
Grade: 5th.
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