Pancho - DIA-ELI-96

Code: DIA-ELI-96
Mercy ID: V-00287-11
Encounter Date: 05/19/1999
Last: Diaz
First: Elizabeth
DOB: 11/17/1996
County: Gwinnett
Street: 3364 Fairway Oaks Apt. 1-A
City: Lawrenceville
State: GA

Zip

30044-

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Patricia Orosco	01/16/1971	Mexico
Father	Roberto Diaz	06/06/1969	Mexico
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: father
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: Y. Garcia