Pancho - MAR-MEL-95

Code: MAR-MEL-95
Mercy ID: V-00188-11
Encounter Date: 08/16/2000
Last: Marquez
First: Melanie
DOB: 02/19/1995
County: Fulton
Street: 825 Thoe Run B
City: Roswell
State: GA

Zip

30076-

Home

(678) 277-9409

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Norma Gomez	12/30/1976	Mexico
Father	Elmer Marquez	06/01/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Mimosa Elem.
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: K. Aleman
Data Entry: Y. Garcia