Pancho - PAZ-YAJ-06

Code: PAZ-YAJ-06
Mercy ID: V-02964-13
Encounter Date: 12/10/2008
Last: Pazol
First: Yajaira
DOB: 09/29/2007
County: Gwinnett
Street: 4885 Indian Crest Ct.
City: Lilburn
State: GA

Zip

30047-

Home

(770) 923-6987

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Yuridia Diaz	09/21/1984	Mexico
Father	Edgar Pazol	02/12/1974	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
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: C. Martinez
Data Entry: J. Manzo