Pancho - CHA-SIL-91

Code: CHA-SIL-91
Mercy ID: V-00205-12
Encounter Date: 06/07/2000
Last: Chavez
First: Silvia
DOB: 12/03/1991
County: Fulton
Street: 1505 chayahoochee ave lot 60
City: Atlanta
State: GA

Zip

30318-

Home

(404) 350-0525

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alejandra Chavez	08/22/1971	Mexico
Father	Guillermo Chavez	02/21/1958	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Margaret Mitchell
Grade: 3rd.
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: D. Gomez