Pancho - PER-CIN-94

Code: PER-CIN-94
Mercy ID: V-03386-11
Encounter Date: 08/04/2010
Last: Perez
First: Cindy
DOB: 04/24/1994
County: Fulton
Street: 201 Northwood Dr. Apt. G-6
City: Sandy springs
State: GA

Zip

30342-

Cell

(678) 668-6812

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

some high school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Paula Villasana	03/02/1969	Mexico
Father	Pedro Perez-Fallecio	08/08/1960	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: No sabe el nombre
Grade: 11th.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo