Pancho - EST-AZU-01

Code: EST-AZU-01
Mercy ID: V-01248-11
Encounter Date: 07/02/2003
Last: Estrada
First: Azucena
DOB: 09/26/2001
County: Dekalb
Street: 3610 Buford Hwy Apt E8
City: Atlanta
State: GA

Zip

30329-

Home

(404) 248-1712

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Cristina Grajales	09/25/1974	Mexico
Father	Ernesto Estrada	11/07/1974	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: J. Perez
Data Entry: K. Aleman