Pancho - JUA-MIR-95

Code: JUA-MIR-95
Mercy ID: V-00186-12
Encounter Date: 05/24/2000
Last: Juarez
First: Miralleldy
DOB: 11/26/1995
County: Cobb
Street: 949 sourwood cir
City: Marietta
State: GA

Zip

30060-

Home

(770) 590-7161

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	sara barrera	05/04/1972	Mexico
Father	julio juarez	02/04/1974	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: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: K. Aleman
Data Entry: D. Gomez