Pancho - PER-VAN-00

Code: PER-VAN-00
Mercy ID: V-02994-11
Encounter Date: 01/28/2009
Last: Perez
First: Vanessa
DOB: 05/06/2000
County: Cobb
Street: 7311 Elsner Rd.
City: Austell
State: GA

Zip

30168-

Cell

(678) 260-7047

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	Maria E. Perez	10/09/1977	Mexico
Father	Inocente Vega	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Riverside elem
Grade: 5th.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo