Pancho - MON-JUD-03

Code: MON-JUD-03
Mercy ID: V-03156-12
Encounter Date: 10/14/2009
Last: Monroy
First: Judith
DOB: 03/14/2003
County: Douglass
Street: 4486 Cherokee Dr. L- 56
City: Douglassville
State: GA

Zip

30134-

Cell

(404) 483-8935

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	Blanca Garcia	04/27/1973	Mexico
Father	Armando Monroy	08/18/1968	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Esaid Elem
Grade: 1st.
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