Pancho - ARR-ELE-07

Code: ARR-ELE-07
Mercy ID: W-00003-11
Encounter Date: 09/02/2009
Last: Arreguin
First: Elena
DOB: 02/24/2007
County: Fulton
Street: 1101 Collier Road Unit 1
City: Atlanta
State: GA

Zip

30318-

Home

(419) 966-3409

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Rebecca Rodriguez	03/05/1984	USA
Father	Sam Arreguin	N/A	USA
Step Parent	N/A	N/A	N/A

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