Pancho - PER-KAT-99

Code: PER-KAT-99
Mercy ID: V-01689-11
Encounter Date: 09/15/2004
Last: Perez
First: Katey
DOB: 04/29/1999
County: Gwinnett
Street: 2428 Sweet Stob
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 339-8387

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	H. Morales	12/04/1979	Mexico
Father	Manuel Perez	06/16/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: Kinder
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