Pancho - HER-KIM-02

Code: HER-KIM-02
Mercy ID: V-02258-12
Encounter Date: 06/28/2006
Last: Hernandez
First: Kimberly
DOB: 03/15/2002
County: Dekalb
Street: 3610 Buford Hwy Apt B3
City: Atlanta
State: GA

Zip

30329-

Home

(404) 325-5021

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Erika Rodriguez	12/03/1978	Mexico
Father	Javier Hernandez	04/19/1973	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: R. Gonzalez
Data Entry: R. Gonzalez