Pancho - JET-ADR-90

Code: JET-ADR-90
Mercy ID: V-02218-11
Encounter Date: 04/26/2006
Last: Jeter
First: Adryana
DOB: 12/15/1990
County: Gwinnett
Street: 6369 Brandywine Trail
City: Norcross
State: GA

Zip

30092-

Home

(678) 966-9693

Cell

(404) 255-3782

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Other

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Pasquiel Jeter	07/16/1976	USA
Father	Ruben Valenciano	12/21/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Pinckneyville Middle
Grade: 8th.
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: R. Gonzalez
Data Entry: R. Gonzalez