Pancho - HER-IRI-97

Code: HER-IRI-97
Mercy ID: V-01835-11
Encounter Date: 04/04/2005
Last: Hernandez
First: Iris
DOB: 12/31/1997
County: Gwinnett
Street: 400 Stone Hill Dr.
City: Stone mountain
State: GA

Zip

00000-00

Home

(678) 789-2280

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	Griselda Favela	09/19/1973	Mexico
Father	Juan Hernandez	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
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: K. Aleman
Data Entry: K. Aleman