Pancho - ROM-VAN-98

Code: ROM-VAN-98
Mercy ID: V-03396-11
Encounter Date: 09/29/2010
Last: Romero
First: Vanessa
DOB: 08/13/1998
County: Dekalb
Street: 1512 Brook Ct.
City: Doraville
State: GA

Zip

30340-

Cell

(770) 256-4083

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Hermenegilda Benites	09/30/1980	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Henderson Mill Middle
Grade: 7th.
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: Volunteer
Data Entry: J. Manzo