Pancho - CAJ-JAC-00

Code: CAJ-JAC-00
Mercy ID: V-02494-11
Encounter Date: 05/30/2007
Last: Cajas
First: Jacqueline
DOB: 04/03/2000
County: Gwinnett
Street: 5881 Lanier Blvd.
City: Norcross
State: GA

Zip

30071-

Cell

(678) 368-3557

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Francisca Gallardo	09/27/1961	Mexico
Father	Rudiel Cajas	01/03/1958	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Norcross Elem
Grade: 1st.
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: Y. Garcia
Data Entry: J. Manzo