Pancho - GOD-SEL-98

Code: GOD-SEL-98
Mercy ID: V-01896-11
Encounter Date: 05/18/2005
Last: Godinez
First: Selene
DOB: 12/26/1998
County: Dekalb
Street: 2235 Plaster Rd. Apt 1
City: Atlanta
State: GA

Zip

30345-

Cell

(678) 886-8880

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	Blanca Godinez	02/14/1971	Mexico
Father	Geremias Mejia Bartolo	07/24/1976	Guatemala
Step Parent	N/A	N/A	N/A

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