Pancho - URI-VIR-96

Code: URI-VIR-96
Mercy ID: V-01830-11
Encounter Date: 03/02/2005
Last: Uriostegui
First: Virginia
DOB: 11/12/1996
County: Cobb
Street: 1101 Gallery Lane
City: Smyrna
State: GA

Zip

30080-

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	Catalina Uriostegui	04/30/1970	Mexico
Father	Nemesio Antunez	10/31/1970	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: 2nd.
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