Pancho - ROD-STE-00

Code: ROD-STE-00
Mercy ID: V-01357-11
Encounter Date: 10/08/2003
Last: Rodriguez
First: Stephanie
DOB: 01/20/2000
County: Gwinnett
Street: 1475 Chalet Circle
City: Lawrenceville
State: GA

Zip

30043-

Home

(770) 995-1470

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	Karina Robledo	01/17/1980	Mexico
Father	Filiberto Rodriguez	01/14/1967	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: Y. Garcia
Data Entry: K. Aleman