Pancho - MAR-SAN-94

Code: MAR-SAN-94
Mercy ID: V-01522-12
Encounter Date: 03/17/2004
Last: Martinez
First: Sandra
DOB: 08/29/1994
County: Gwinnett
Street: 861 Simon Park Circle
City: Lawrenceville
State: GA

Zip

00000-0000

Home

(770) 995-5209

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Araceli Atrisco	03/21/1971	Mexico
Father	Carlos Martinez	02/17/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 4th.
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: Volunteer
Data Entry: K. Aleman