Pancho - MAR-EST-02

Code: MAR-EST-02
Mercy ID: V-03263-11
Encounter Date: 02/24/2010
Last: Marin
First: Estefanie
DOB: 12/05/2002
County: Dekalb
Street: 3193 Buford Hwy. Apt. A
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 399-1269

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Elena Rendon	02/15/1973	Mexico
Father	Guillermo Marin	10/20/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: mom
Name of School: Windwood Elem.
Grade: 2nd.
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