Pancho - TOV-DAN-03

Code: TOV-DAN-03
Mercy ID: V-01997-11
Encounter Date: 05/06/2009
Last: Tovar
First: Danielle
DOB: 11/27/2003
County: Gwinnett
Street: 3728 Burnt Leaft lane
City: Snellville
State: GA

Zip

30039-

Cell

(770) 905-1810

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Claudia Tovar	01/29/1978	Colombia
Father	Jesus Tovar	01/11/1974	Colombia
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: C. Martinez
Data Entry: J. Manzo