Pancho - MEJ-DAY-03

Code: MEJ-DAY-03
Mercy ID: V-01896-12
Encounter Date: 05/18/2005
Last: Mejia
First: Dayana a
DOB: 03/10/2003
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

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Blanca Godinez	02/14/1971	Mexico
Father	Geremia Mejia	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: 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: Y. Garcia
Data Entry: K. Aleman