Pancho - MAR-ADR-95

Code: MAR-ADR-95
Mercy ID: V-00248-12
Encounter Date: 08/23/2000
Last: Martinez
First: Adriana
DOB: 07/20/1995
County: Fulton
Street: 5140 jonesboro rd
City: Union city
State: GA

Zip

30291-

Home

(770) 306-1597

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	josefina martinez	03/19/1966	Mexico
Father	enemorio martinez	09/07/1962	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: campell elemtary
Grade: 5th.
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: S. Aviña