Pancho - JIM-AND-99

Code: JIM-AND-99
Mercy ID: V-03191-11
Encounter Date: 10/21/2009
Last: Jimenez
First: Andrea
DOB: 02/02/1999
County: Clayton
Street: 444 Cedar Court
City: Riverdale
State: GA

Zip

30274-

Home

(770) 603-2717

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Martha Torrez	01/17/1974	Mexico
Father	Alvaro Jimenez	05/18/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Porut South Elem.
Grade: 5th.
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