Pancho - MOL-CAR-99

Code: MOL-CAR-99
Mercy ID: V-01691-11
Encounter Date: 09/22/2004
Last: Molina
First: Carla denny
DOB: 09/13/1999
County: Fulton
Street: 3315 Roswell Rd. Apt B7
City: Atlanta
State: GA

Zip

30305-

Cell

(404) 484-0085

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Lilia Sujo	05/01/1982	Mexico
Father	Roberto Molina	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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