Pancho - MAL-MAR-99

Code: MAL-MAR-99
Mercy ID: V-01703-11
Encounter Date: 09/29/2004
Last: Maldonado
First: Marina
DOB: 04/27/1999
County: Fulton
Street: 1170 Woodland Ave.
City: Atlanta
State: GA

Zip

30324-

Home

(404) 325-2277

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	Leticia Mena	09/03/1980	Mexico
Father	Omar Maldonado	09/19/1981	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Garden Hill
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