Pancho - CHA-CHI-94

Code: CHA-CHI-94
Mercy ID: V-01591-11
Encounter Date: 05/26/2004
Last: Chavez
First: Chiara
DOB: 05/14/1994
County: Fulton
Street: 202 Morgan Landing Dr.
City: Atlanta
State: GA

Zip

30350-

Home

(770) 698-8488

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Milagrso Cuzquen	01/12/1967	Perú
Father	Guillermo Chavez	09/23/1975	N/A
Step Parent	Luis Felipe Ego Aguirre	09/09/1966	Perú

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Woodland Elementary
Grade: 5th.
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: I. Rodrigue
Data Entry: K. Aleman