Pancho - APA-SUS-03

Code: APA-SUS-03
Mercy ID: V-03169-12
Encounter Date: 10/21/2009
Last: Aparicio
First: Susana
DOB: 05/07/2003
County: Gwinnett
Street: 5911 Hunt Club Run # D
City: Norcross
State: GA

Zip

30093-

Cell

(770) 369-0910

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	Susana Aparicio	09/30/1976	Mexico
Father	Luis E. Silva	10/30/1973	Mexico
Step Parent	N/A	N/A	N/A

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