Pancho - HID-LUI-03

Code: HID-LUI-03
Mercy ID: V-01261-11
Encounter Date: 07/17/2003
Last: Hidalgo rosario
First: Luisiana
DOB: 04/21/2003
County: Dekalb
Street: 414 Brian Lake
City: Atlanta
State: GA

Zip

30345-

Home

(404) 634-5945

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	Maria A. Hidalgo	02/18/1958	Dominican Rep
Father	Eusebio L. Rosario	N/A	Dominican Rep
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