Pancho - MON-JEN-91

Code: MON-JEN-91
Mercy ID: V-01284-11
Encounter Date: 10/01/2001
Last: Montero
First: Jennifer
DOB: 12/01/1991
County: Gwinnett
Street: 3825 Bromulo Trace
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 921-6397

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Norena Corrales	08/12/1968	Colombia
Father	Daniel Corrales	N/A	Colombia
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 6th.
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