Pancho - PAC-MEL-01

Code: PAC-MEL-01
Mercy ID: V-02866-11
Encounter Date: 08/06/2008
Last: Pacheco
First: Melani
DOB: 05/05/2001
County: Cobb
Street: 750 Six Flags Road Lot #261
City: Austell
State: GA

Zip

30161-

Home

(770) 739-4925

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Yenitza Jacinto	03/07/1982	Mexico
Father	Jorge Pacheco	06/03/1974	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Riverside 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: F. Gomez
Data Entry: J. Manzo