Pancho - SAL-KAS-93

Code: SAL-KAS-93
Mercy ID: V-02014-12
Encounter Date: 04/23/2007
Last: Salazar
First: Kassandra
DOB: 05/21/1993
County: Dekalb
Street: 2953 North Dekalb Dr. # 202
City: Doraville
State: GA

Zip

30340-

Home

(770) 414-6863

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Blanca Flores	08/14/1972	Mexico
Father	Selvin Flores	01/31/1980	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Lakeside HS
Grade: 9th.
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: G. Landeros
Data Entry: J. Manzo