Pancho - MER-MAR-07

Code: MER-MAR-07
Mercy ID: V-03114-11
Encounter Date: 11/25/2009
Last: Mercado
First: Maria
DOB: 02/17/2007
County: Dekalb
Street: 3658 Buford Hwy
City: Atlanta
State: GA

Zip

30329-

Cell

(678) 927-4974

Family Status

Child/Youth

COB

USA

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Reyna Garcia	N/A	Mexico
Father	Cesar Mercado	01/13/1974	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: C. Martinez
Data Entry: J. Manzo