Pancho - MIR-PAU-07

Code: MIR-PAU-07
Mercy ID: V-02584-11
Encounter Date: 09/19/2007
Last: Miralrio
First: Paula
DOB: 01/21/2007
County: Fulton
Street: 53 Roswell Rd.
City: Roswell
State: GA

Zip

30342-

Home

(404) 257-3310

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Gabriela Villanueva	12/21/1980	Mexico
Father	Esteban Miralrio	08/04/1978	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: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: J. Manzo