Pancho - VIL-ALE-03

Code: VIL-ALE-03
Mercy ID: V-02220-11
Encounter Date: 04/19/2006
Last: Villarreal labastida
First: Alexa elisabeth
DOB: 05/15/2003
County: Fulton
Street: 1021 Cedar Avenue Apt #2
City: East point
State: GA

Zip

30344-

Home

(404) 761-0136

Cell

(404) 425-8576

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Dayana Labastida	12/23/1980	Mexico
Father	Emmanuel Villareal	05/31/1980	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: R. Gonzalez
Data Entry: R. Gonzalez