Pancho - ESP-STE-00

Code: ESP-STE-00
Mercy ID: V-00121-13
Encounter Date: 05/16/2002
Last: Espinoza
First: Stephanie
DOB: 05/17/2000
County: Gwinnett
Street: 4486 Cherokee Dr. Lot 58
City: Douglasville
State: GA

Zip

30134-

Home

(678) 838-9394

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alma Espinoza	02/28/1976	Mexico
Father	Octavio Espinoza	07/18/1972	Mexico
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: K. Aleman
Data Entry: Y. Garcia