Pancho - MEN-DEP-97

Code: MEN-DEP-97
Mercy ID: V-00311-12
Encounter Date: 06/05/2002
Last: Mendez
First: Dephane
DOB: 01/22/1997
County: Gwinnett
Street: 2825 Hamil Chase Dr.
City: Buford
State: GA

Zip

30519-

Home

(770) 271-1617

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Margarita Mendez	09/14/1976	Mexico
Father	Ismael Mendez	06/17/1968	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Armony Elementary
Grade: Kinder
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: Y. Garcia
Data Entry: K. Aleman