Pancho - AGU-JEN-00

Code: AGU-JEN-00
Mercy ID: V-01222-11
Encounter Date: 05/14/2003
Last: Aguirre
First: Jennifer
DOB: 07/17/2000
County: Gwinnett
Street: 842 Downing St.
City: Lawrenceville
State: GA

Zip

30045-

Home

(404) 434-4217

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	Dora Aguirre	05/09/1980	Colombia
Father	Juventino Aguirre	09/09/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: North Metor
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