Pancho - CAM-VAL-99

Code: CAM-VAL-99
Mercy ID: V-01916-12
Encounter Date: 06/15/2005
Last: Camacho
First: Valeria
DOB: 05/07/1999
County: Dekalb
Street: 3061 Oak Cliff Rd. Apt 77
City: Doraville
State: GA

Zip

30340-

Home

(770) 934-0731

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Mildred Hernandez	03/30/1975	Nicaragua
Father	Felix Camacho	03/06/1974	Cuba
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 1st.
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