Pancho - VAR-VIR-03

Code: VAR-VIR-03
Mercy ID: V-02846-11
Encounter Date: 07/30/2008
Last: Vargas
First: Viridiana
DOB: 01/23/2003
County: Dekalb
Street: 6750 Peachtree Ind. Blvd. Apt. 502
City: Atlanta
State: GA

Zip

30360-

Cell

(404) 484-7409

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Adelina Vargas	02/17/1974	Mexico
Father	N/A	N/A	Mexico
Step Parent	Miguel Cambron	N/A	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: N/A
Grade: Kinder
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: C. Martinez
Data Entry: J. Manzo