Pancho - VEL-ALE-97

Code: VEL-ALE-97
Mercy ID: V-01462-11
Encounter Date: 01/07/2004
Last: Velasquez
First: Alexia
DOB: 11/14/1997
County: Dekalb
Street: 1605 Briarwood Rd.
City: Atlanta
State: GA

Zip

30319-

Home

(678) 760-6817

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maricela Velasquez	09/13/1979	Mexico
Father	N/A	N/A	Mexico
Step Parent	Jorge Marin	04/15/1973	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: N/A
Grade: Pre-K
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