Pancho - DIA-MEL-92

Code: DIA-MEL-92
Mercy ID: V-01670-11
Encounter Date: 08/04/2004
Last: Diaz tapia
First: Meliza
DOB: 12/23/1992
County: Dekalb
Street: 1206 Winters Creek Dr.
City: Doraville
State: GA

Zip

30360-

Home

(404) 447-4766

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Guadalupe Tapia	05/15/1975	Mexico
Father	N/A	N/A	Mexico
Step Parent	Santiago Ibarra	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Peachtree Middle School
Grade: 6th.
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