Pancho - RIV-JEN-05

Code: RIV-JEN-05
Mercy ID: V-02481-11
Encounter Date: 05/02/2007
Last: Rivera
First: Jennifer
DOB: 04/14/2005
County: Fulton
Street: 3510 Buford Hwy
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 396-0780

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Shelter

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Eugenia Canales	12/05/1975	Honduras
Father	Joel Rivera	09/12/1982	Honduras
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: Volunteer
Data Entry: J. Manzo