Pancho - HER-AYA-97

Code: HER-AYA-97
Mercy ID: V-00218-11
Encounter Date: 06/07/2000
Last: Hernandez
First: Ayari
DOB: 09/10/1997
County: Gwinnett
Street: 1327 Robin Hill Dr
City: Norcross
State: GA

Zip

30093-

Home

(770) 925-1453

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Marina Rosa	03/03/1968	El Salvador
Father	Jose Ismael Hernandez	04/01/1965	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: N/A
Grade: N/A
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