Pancho - SAN-ALL-97

Code: SAN-ALL-97
Mercy ID: V-01312-12
Encounter Date: 06/15/2004
Last: Santa
First: Allison
DOB: 12/14/1997
County: Dekalb
Street: 2872 Marlyn Dr.
City: Chamblee
State: GA

Zip

30341-

Home

(404) 246-9014

Family Status

Attached youth

COB

Honduras

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Diana Espinal	08/24/1958	Honduras
Father	Ivan Santa	N/A	Honduras
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: K. Aleman
Data Entry: K. Aleman