Pancho - MOL-DEG-01

Code: MOL-DEG-01
Mercy ID: V-01897-13
Encounter Date: 05/18/2005
Last: Molina
First: Degny
DOB: 11/01/2001
County: Fulton
Street: 3144 Martin Luther King Jr. Rd. D6
City: Atlanta
State: GA

Zip

30311-

Home

(404) 696-5267

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Mirely Mena	07/26/1972	Honduras
Father	Degni Molina	N/A	Honduras
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: Y. Garcia
Data Entry: K. Aleman