Pancho - SAL-ELS-03

Code: SAL-ELS-03
Mercy ID: V-03245-12
Encounter Date: 01/27/2010
Last: Salazar
First: Elsa
DOB: 12/29/2003
County: Clayton
Street: 629 Redfox Trail
City: Jonesboro
State: GA

Zip

30238-

Cell

(404) 453-5767

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Diana Garcia	04/18/1984	Mexico
Father	Luis Miguel Salazar	08/25/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Hawthorne Elem
Grade: Kinder
Who Can't Pickup the Child: father
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perilla
Data Entry: J. Manzo